New Report Calls for the UK Government to Act on Global Health

September 15th, 2020 – The Action for Global Health network has today released a report which calls for the UK to strengthen its contributions to global health to mitigate the impact of the COVID-19 crisis and build resilient health systems around the world. The report, titled “A Stocktake Review: Strengthening the UK’s Commitments to Global Health”, evaluates the level and composition of UK Official Development Assistance (ODA) to health over time, with recommendations for the UK Government to improve its approach to global health.

Professor Mala Rao OBE (Senior Clinical Fellow at Imperial College London), Professor Robyn Norton (Principal Director at The George Institute for Global Health) and Kevin Watkins (CEO at Save the Children UK) are amongst leading thinkers in the network to raise concerns about the findings highlighted by the report. The report states that without effective and urgent action by the UK Government, countries could risk losing decades of health progress as the world tries to recover from the impacts of COVID-19.

The report analyses extensive data on the UK’s political, financial and programmatic contributions and finds that despite the UK’s contributions to achievements in health over the last 20 years, undeniable challenges remain and significant improvements must be made.

Key findings

• Following the recent merger of the Foreign and Commonwealth Office (FCO) and Department for International Development (DFID), global health and the manifesto commitment to ‘end preventable deaths’ were absent from the list of priorities for the new department.
• The UK Government has not had a public strategy guiding its work in global health since 2013. Additionally, a Health Systems Strengthening Position Paper has been under preparation for over four years, but no date for publication is as yet confirmed. Similarly, no date for publication has been confirmed for the UK Government’s ‘Action Plan’ on ‘ending preventable deaths’.
• After a dip in overall amounts of ODA to health between 2013-16, the UK’s total health spending has not yet returned to 2013 levels. Similarly, UK health spending as a share of total ODA has declined significantly since 2013.
• Health ODA channelled to Southern actors is particularly low; aid channelled through international NGOs, or NGOs based in donor countries, occupied 93% of all NGO finance from the UK ODA to health pot in 2018. For the two years with available data (since 2017), 95-96% of health ODA to the private sector was channelled to private actors in the provider (i.e. donor) country.
• Whilst UK programmes have expanded access across a number of essential health services, the UK neglects health system components in their programming and there has been insufficient focus on strengthening national health infrastructure to deliver sustainable improvements.
• The UK allocates very little ODA to programmes dedicated to supporting the training, recruitment and retention of health workers.

In light of COVID-19, the world is grappling with the severe direct and indirect health impacts of the pandemic and the ability of health systems to deliver essential health services. Up to 80 million children under the age of one are at risk of missing out on routine immunisations for diseases such as measles, polio and yellow fever and 49 million more women could have their needs for modern contraception neglected (see AfGH’s indirect impacts briefing). Leaders must urgently tackle the shortfalls identified in the report and ensure the UK’s interventions play a key role in the global effort to build healthier and safer futures beyond the COVID-19 crisis.

“The UK must improve its approach to global health to ensure equitable access to healthcare everywhere,” said Professor Mala Rao OBE, Senior Clinical Fellow, Imperial College London, Medical Advisor on Workforce Race Equality Strategy to NHS England and advisor to THET. “While we must celebrate the tremendous gains and breakthroughs that the UK has contributed to, this report indicates that it can and simply must do more. As the world begins to build back from the public health crisis defining our times, it is critical that decision makers consider the risks at stake if they fail to invest sufficiently in health systems and health workers around the world.”

“This report underscores the key role the UK has to play in supporting better health outcomes globally as we rebuild after the COVID-19 pandemic; not least through investment in research into how countries around the world can build equitable, integrated health systems that address infectious and chronic diseases alike.” said Professor Robyn Norton, Principal Director at The George Institute for Global Health and Acting Executive Director of The George Institute for Global Health, UK.

“The money we spend on health keeps children alive worldwide. Any deprioritisation of this spending would weaken health services that are already fragile and hit poor people hardest.” said Kevin Watkins, CEO at Save the Children UK. “The COVID-19 pandemic has left many children and their families without access to vital health and nutrition services – and the UK now has a critical part to play in making sure everyone gets the care they need, wherever they’re born.”

The report outlines recommendations for how the UK Government can strengthen its contributions to global health in the coming years and prepare to rebuild from the challenges COVID-19 has exacerbated, whilst managing future threats to global public health.

The recommendations come as the new Foreign, Commonwealth and Development Office (FCDO) recently opened its doors. In light of recent cuts to the ODA budget, the report argues that this is a critical turning point for the new department to centre global health as a priority in how this budget is divided and to be at the forefront of efforts to build a healthier world. Ahead of a year in which the UK takes on the presidencies of the G7 and COP26 summits, the network urges the UK to lead by example and promote an ambitious vision for building resilient and inclusive health systems everywhere.

“2020 is a critical moment in history for the UK to review its commitment to creating a healthier world,” said Katie Husselby, Coordinator at Action for Global Health. “COVID-19 continues to expose the dark underbelly of under-funded and under-resourced health systems. We need an urgent, whole-of-government response to mitigate the impacts of this crisis and future proof our approach to global health for current and future generations.”

About Action for Global Health

Action for Global Health is a UK-based influential membership network convening more than 50 organisations working in global health. As a membership organisation, we convene, connect and mobilise global health advocates to hold the UK government and other global health stakeholders accountable to achieve our agreed strategic goals.