COOPERATION IN HEALTH DEVELOPMENT IN LATIN AMERICA AND THE CARIBBEAN IN THE GLOBAL CONTEXT:

CHALLENGES AND OPPORTUNITIES

Dr. Rebecca de los RíosPrincipal Advisor

External Relations, Partnerships andResource Mobilization

delosrir@paho.org

Leaders in International Health ProgramCooperation and Diplomacy in Health Module

2012 Session

Milestone that marked a shift: 2000 Millennium Summit

IV Forum Busan Korea

Why use graphics from PowerPointing.com?

1st High-Level Forum in RomeHarmonization

Doha Declaration on

Financing for Development

Monterrey Consensus

Commitment of 0.7%

II ForumParis

Declaration

20032002 2005 2008 2010 2011

Millenium Development Goals (MDGs)

Global Meetings on Cooperation for Development

III Forum Action

Agenda of Accra

Forum on Cooperation

for Development

ECOSOC

High Level Forum on SSCBogota

Declaration

Forum on Cooperation for

DevelopmentECOSOC

World Develop-

ment Summit

Have the member countries of the CAD fulfilled their commitment?

If they had fulfilled their commitment, the annual amount available would be 300 billion dollars. But it is only 133 billion dollars. What to do?

Paris Declaration: Global Commitments of Donors and Partners

Agreed upon by those who signed and/or endorsed the Agenda of Aid Effectiveness

The agreements continually changed: A New geopolitics of cooperation for development

Second High Level Forum on Joint Progress toward Enhanced Aid Effectiveness (Harmonisation, Alignment, and Results

It proposes improvement in the areas of ownership, partnerships and delivering results..Capacity development also lies at the heart of the Agenda for Action.There is a reconigtion of the role of Soutth-South Cooperation

Busan has been an expression of shifting geopolitical realities: For a New Global Partnership for Development

What Happened in Health: Expansion and Presence of New Actors Financing Global Health

Taken from “Financing Global Health 2011: Continued Growth as MDG Deadline Approaches” Institute of Health Metric and Evaluation. University of Washington. 2011

New Actors Appear: Public-Private Partnerships, NGOs

Multiple Global Initiatives

Where are Latin America and the Caribbean in the Global Context?

Taken from “Financing Global Health 2011: Continued Growth as MDG Deadline Approaches” Institute of Health Metric and Evaluation. University of Washington. 2011

How has international aid grown since the Millennium Summit?

Source: De Los Ríos R, Arósquipa C, Vigil-Oliver W. Rev Panam Salud Publica. 2011;30(2)133–43

Variación porcentual de la asistencia para el desarrollo de la salud

Source: Done by PAHO/WHO based on IHME DAH Database Country and Regional Recipient Level Database 1990-2009. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2011; retrieved: Jan 2012Note: Abbreviations: CAD: Development Aid Committee (DAC); BIRF: International Bank for Reconstruction and Development; IDA: International Development Association; BID: Inter American Development Bank (IDB); GAVI: Global Alliance on Vaccines and Immunizations; FBMG: Bill and Melinda Gates Foundation

Growth Dynamics: Volatile and CyclicalFinanciamiento de la asistencia internacional para el desarrollo de la salud (ADS) por fuente en la Región de América Latina y el Caribe. 1990-2009 (desembolsos en millones de dólares constantes de 2009)

There are differences according to the per-capita income of countries

http://ais.paho.org/phip/viz/ERP_AOD_Salud_LAC_GruposIngreso_esp.asp

Source: De Los Rios, R; Vilanova Carmen based on Credit Reporting System . OECD.Stat Extracts, http://stats.oecd.org/index.aspx?DataSetCode=CRS1, date retrieved: March-April, 2012 ;

Note: According to World Bank data, the high income countries are Antigua & Barbuda, Barbados, Netherlands Antilles, Turks & Caicos, Trinidad & Tobago; middle-high income countries are Argentina, Belize, Chile, Costa Rica, Cuba, Dominica, Grenada, Jamaica, Mexico, Panama, Saint Kitts & Nevis, Saint Lucia, Saint Vincent & the Grenadines, Suriname, Uruguay, Venezuela; low-middle income countries are Bolivia, Brazil, Colombia, Ecuador, El Salvador, Guatemala, Guyana, Honduras, Nicaragua, Paraguay, Peru, República Dominicana; low income country is Haiti; Regional/multi-country includes the region and sub-regions of Central America, South America and the West Indies

Financing by Developed CountriesOfficial Health Development Aid according to group of entry of countries by year, 2002-2010 (Millions of U.S. Dollars at constant prices 2010)

Source: Developed by PAHO/WHO based on statistics of the Creditor Reporting System. OECD.Stat Extracts, http://stats.oecd.org/index.aspx?DataSetCode=CRS1, date retrieved: March-April, 2012 Notes: Medical services and research: includes academic training of the health personnel and medical services specialized in medical researchBasic Health: includes basic health, basic health infrastructure, training staff in basic health and health educationInfectious diseases: includes control of infectious diseases, malaria and tuberculosis Reproductive health and family planning: includes reproductive health, family planning and training of staff working in reproductive health and family planning

Alignment with Regional Health Problems?

Ayuda oficial al desarrollo (AOD) por tema de salud en América Latina y el Caribe(acumulado 2002-2010)

Source: Developed by PAHO/WHO from the statistical database of the OECD Creditor Reporting System, http://stats.oecd.org/index.aspx?DataSetCode=CRS1, date retrieved: March-April, 2012 NOTES: Nordic countries include: Denmark, Finland, Norway and SwedenThe rest of the countries include: Australia, Austria, Belgium, France, Greece, Ireland, Italy, Luxemburg, United Kingdom and Switzerland

Who are the principal cooperating countries?

Ayuda Oficial al Desarrollo en Salud (AOD-S) según país cooperante en América Latina y el Caribe, 2002-2010 (Millones US$ precios constantes 2010)

How has International Aid to Governments for the Development of Health behaved before and after

the year 2000?

Source: De Los Ríos R, Arósquipa C, Vigil-Oliver W. Rev Panam Salud Publica. 2011;30(2)133–43.

What is the variation of Public Health Expenditures before and after the year 2000?

GPS-F: Public spending on health as a source. This refers to government expenses that are financed by internal sources. Source: De Los Ríos R, Arósquipa C, Vigil-Oliver W. Rev Panam Salud Publica. 2011;30(2)133–43.

Challenges: Donor Relations

•Promote less circumstantial cooperation, focusing on capacity development and processes aimed at facilitating greater sustainability.

•A partnerships where donors meet the internationally agreed upon principles such as harmonization, alignment, coordination and above all, the recognition of the stewardship role of governments.

August 2011

Vol. 30, No. 2

NÚMERO ESPECIAL SOBRE SALUD INTERNACIONAL / SPECIAL ISSUE ON INTERNATIONAL HEALTH

El financiamiento internacional para la cooperación al desarrollo de la salud de América Latina y el Caribe

Rebecca De Los Ríos, Carlos Arósquipa y William Vigil-Oliver

http://new.paho.org/journal

Importance of Evidence and Information for Dialogue with Donors

Ayuda Oficial para el Desarrollo de la Salud según países receptores, donantes y años

http://ais.paho.org/phip/viz/ERP_ADS_Salud_LAC_esp.asp

Challenge in the models: Innovative cooperation

• Changing the paradigm, seeking non-traditional funding mechanisms, articulating actors, establishing alliances and partnerships (public-private partnerships, joint civil society, academia, etc.)

• Mobilizing resources, ideas, innovations, and capacities of countries in the region to mutually beneficial partnerships.

Opportunities

•Countries have better capacities and knowledge to share: leadership of middle income countries.

•Health problems are increasingly shared.

•The answers and solutions are becoming more collaborative

Regional leadership promoting cooperation among countries for the development of health.

The exchange of knowledge and joint learning: A necessity for cooperation in health.

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We hope that this presentation will provide you with elements that foster

discussions and debates

Muchas Gracias

Thank You

Muito Obrigada