Saving Lives

AusAID’s approach to health in developing countries

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Significant health issues are facing the region

Maps: Lonely Planet

Under-nutrition

Artemisinin resistance

Poor maternal health and child health

HIV infection

Weak health system

Non-communicable

diseases

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There is a major funding gap for health> USD 54 per person on

health annually required to meet health MDGs

> In 2009, health spending was USD 25 per person in low-income countries USD 10 paid by patients

‘out-of-pocket’

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But funding alone is insufficient: donors must engage countries on health policy and reform

> ODA accounts for only around 0.3% of total expenditures on global development health

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To focus health assistance on the poorest> Child mortality rates

generally highest within the poorest 20% of a population

> Poor coverage and quality of health services and poor “health seeking behaviour”

> Influenced by wider social determinants

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And build equitable health systems to improve maternal and child health

Health centres

Data on maternal health needs

Maternal health policy

Essential medicines

Trained midwives

Sufficient funding

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Health assistance must also work within a complex international health ‘architecture’

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Saving lives is a goal of Australia’s aid program

In addition, Australia aims to improve public health by increasing access to safe water and sanitation

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Australia invests in health because> Improving people’s health is a critical aim of international

development > Good health helps achieve other development goals, such as

economic growth and poverty reduction> Australia can contribute to improving the health of the

poorest people, particularly in Asia and the Pacific> Investing in health is in Australia’s national interest

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Australia is focusing on six priorities for our health investment, guided by four key principles

2. Closing the funding gap2. Closing the funding gap

1. Supporting health services for poor people1. Supporting health services for poor people

3. Empowering poor people to improve their health

3. Empowering poor people to improve their health

4. Working across sectors4. Working across sectors

5. Addressing regional and global threats5. Addressing regional and global threats

6. Maximising the impact of our investment6. Maximising the impact of our investment

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Australia has six priorities for our health investment, guided by four key principles

2. Closing the funding gap2. Closing the funding gap

1. Supporting health services for poor people1. Supporting health services for poor people

3. Empowering poor people to improve their health

3. Empowering poor people to improve their health

4. Working across sectors4. Working across sectors

5. Addressing regional and global threats5. Addressing regional and global threats

6. Maximising the impact of our investment6. Maximising the impact of our investment

Focussed on the

poorest

Focussed on the

poorest

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Australia has six priorities for our health investment, guided by four key principles

2. Closing the funding gap2. Closing the funding gap

1. Supporting health services for poor people1. Supporting health services for poor people

3. Empowering poor people to improve their health

3. Empowering poor people to improve their health

4. Working across sectors4. Working across sectors

5. Addressing regional and global threats5. Addressing regional and global threats

6. Maximising the impact of our investment6. Maximising the impact of our investment

Focussed on the

poorest

Focussed on the

poorestCountry-ledCountry-led

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Australia has six priorities for our health investment, guided by four key principles

2. Closing the funding gap2. Closing the funding gap

1. Supporting health services for poor people1. Supporting health services for poor people

3. Empowering poor people to improve their health

3. Empowering poor people to improve their health

4. Working across sectors4. Working across sectors

5. Addressing regional and global threats5. Addressing regional and global threats

6. Maximising the impact of our investment6. Maximising the impact of our investmentContext-specific

Context-specific

Focussed on the

poorest

Focussed on the

poorestCountry-ledCountry-led

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Australia has six priorities for our health investment, guided by four key principles

2. Closing the funding gap2. Closing the funding gap

1. Supporting health services for poor people1. Supporting health services for poor people

3. Empowering poor people to improve their health

3. Empowering poor people to improve their health

4. Working across sectors4. Working across sectors

5. Addressing regional and global threats5. Addressing regional and global threats

6. Maximising the impact of our investment6. Maximising the impact of our investmentContext-specific

Context-specific

Focussed on the

poorest

Focussed on the

poorestCountry-ledCountry-led

Backed by evidence

Backed by evidence

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1. Australia is supporting health services for poor people> Advocating for health systems that provide equitable

access to quality health services > Supporting partner countries to identify and respond

to their own health priorities> Promoting cost-effective interventions> Targeted support in humanitarian and fragile

situations> Supporting multilateral agencies

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Case study: East TimorContext> Fragile state emerging from

conflict> Communicable diseases

major cause of death> Maternal mortality rate:

440 per 100,000 live births > AusAID is largest donor for

health, but significant UN and other development partner presence Map: Lonely Planet

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Case study: East TimorMixed modalities approach> Estimated $10 million for health in 2010-11> Strengthening government systems (through World Bank trust fund)> Supporting NGOs to provide direct service delivery (in partnership with

USAID)> Filling gap in specialised surgical services

Impact> Skilled birth attendance has increased from 35% (2008) to 46.7% (2009) > Infant mortality has decreased from 60 deaths per 1,000 live births (2003)

to 44 deaths per 1,000 live births

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2. Australia is helping to close the funding gap

> Increased resources through a range of avenues Health budget support Pooled funding arrangements Working with other donors on joint programs

> Advocating for increased, and better targeted, national health budgets Reducing out-of-pocket payments Better use of non-state sector

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Case study: Solomon Islands

Context> Post-conflict state> Weak health system> Malaria endemic region> Rising non-communicable

diseases> Australia is the major donor

for the health system

Map: Lonely Planet

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Case study: Solomon IslandsBudget support approach> Estimated $18 million for health in 2010-11> Sectoral budget support, providing 40% of annual health budget> Focus on supporting Solomon Islands Government to deliver effective,

efficient and equitable health services> Long-term and predictable financial support to government systems > Work with other development partners> Pacific regional mechanisms

Impact> Malaria cases have more than halved between 2003 and 2009

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3. Australia is empowering poor people to improve their health> Supporting poor and vulnerable people to demand

and access affordable, quality health care Supporting civil society to demand quality care Providing incentives for people to access health care (eg.

Voucher schemes, conditional cash transfers) Reducing ‘out-of-pocket’ payments

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4. Australia is tackling the broader causes of ill health > Social determinants of health include: income,

education, gender inequality, food (in)security> Multi-sectoral efforts to reduce non-communicable

diseases> Working across education, rural development, social

protection, gender inequality to address broader causes of ill-health

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5. Australia is reducing the impact of global and regional health threats> Pandemic preparedness > Tackling malaria drug resistance> Responding to natural disasters> Adapting to climate change

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6. Australia is maximising the impact of Australia’s investment> Aligning assistance to national priorities> Coordinating with other donors> Ensuring multilateral agencies are effective> Building the evidence base

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Case study: NepalContext> Least developed country> Malnutrition major problem> Increasing non-communicable

diseases> Busy donor environment: World

Bank, DFID, USAID, GTZ, Asian Development Bank, JICA, AusAID

> Government budget allocation to health progressively increased (7% GDP)

Map: Lonely Planet

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Case study: NepalPooled funding approach> Estimated $10 million for health in 2010-11> Contribute to Nepal’s health sector program through joint

financing arrangement > Good donor coordination mechanism> AusAID influences health outcomes at policy level

Impact> Under five mortality rate decreased from 61 per 1,000 live

births in 2006 to 50 in 2009

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Australia’s focus is on the Asia-Pacific region, with increasing support to Africa

Pacific IslandsPacific Islands

• Strong health system• Delivering health

services • Maternal and child

health and high-burden infectious diseases

• Prevention and control of non-communicable diseases

• Building a sustainable health workforce

• Strong health system• Delivering health

services • Maternal and child

health and high-burden infectious diseases

• Prevention and control of non-communicable diseases

• Building a sustainable health workforce

South and South-East Asia

South and South-East Asia• Working with partner

governments • Supporting quality

health services for the poorest people

• Strengthening health systems

• Focus on communicable diseases and maternal and child health

• Working with partner governments

• Supporting quality health services for the poorest people

• Strengthening health systems

• Focus on communicable diseases and maternal and child health

AfricaAfrica

• Targeted support for maternal and child health, focusing on East Africa

• Working with experienced to strengthen the delivery of health services.

• Targeted support for maternal and child health, focusing on East Africa

• Working with experienced to strengthen the delivery of health services.