Guidance

Leaving no one behind? Considering the Impact of Donor Transition

Aid to health has been instrumental in improving health outcomes in many places; however, all of these gains could be undone by a mismanaged donor transition. If donors transition too early, or en masse, then the health system which they have helped to strengthen will come under multiple pressures. It will not automatically receive the financial or technical support its needs to continue to provide current services from domestic resources, nor is there any guarantee of resources expanding beyond replacement levels to reach those currently unreached. At the same time, countries lose access to lower costs for the procurement of health tools. Not only will this diminish the returns of any investment a donor has previously made but more importantly it could mean a deterioration of health services which in many places are already not reaching every person or child with all the services they need. This triple burden of reduced support, increased costs and a pressing need to continue to expand coverage to reach those still missed could result in more children missing out on vaccinations, more children growing up stunted or rates of TB increasing. Where there are already high rates of disease burden, transition is likely to exacerbate these problems. For example, in Romania the withdrawal of donor support for HIV programmes resulted in a rise in HIV rates among people who inject drugs from 3.3% of the population in 2009, to 27.5% in 2013. Much of this increase is linked to the lack of funds to provide targeted prevention interventions for people who inject drugs.

Languages

  • English

Publication year

2017

Publisher

RESULTS

Type

Guidance

Categories

  • Programme management

Countries

  • Angola
  • Nigeria
  • Romania

Tags

  • Planning, budgeting and financing
  • Policy and legislation

WHO Regions

  • African Region
  • European Region