U.S. constitutes major source of health development assistance from 1990 to 2014

1. Development assistance for health (DAH) increased substantially from 1990 to 2014, with the U.S. government being the largest contributor of DAH.

2. HIV/AIDS and maternal health/newborn and child health are the two largest health focus areas that received DAH.

Evidence Rating Level: 2 (Good)

Study Rundown: Low-income countries have a dearth of healthcare resources and services, which results in preventable deaths. One way in which high-income countries are a source of healthcare funding for these developing countries is through the developmental assistance for health (DAH) program. DAH has increased over the last 25 years, with certain low-income countries depending heavily on DAH for their total health expenditure.

This study aimed to investigate the contributions of DAH from different countries and organizations as well as to determine the areas of healthcare that received this funding from 1990 to 2014. Approximately $458 billion of health assistance was provided to developing countries from high-income countries over this time period, with the U.S. providing the largest proportion followed by the UK government and private sources. In terms of the health care areas that received this funding, the two most focused areas were HIV/AIDS and maternal health/newborn and child health. Relative to its disease burden, funding for non-communicable diseases was disproportionately limited. The limitations of this study involve the change in data availability and quality over the time period of the analysis. Despite this, the results provide valuable insight into global health funding trends.

Click to read the study, published today in JAMA

Click to read the accompanying editorial, published today in JAMA

Relevant Reading: World Health Organization. Global health expenditure database

In-Depth [retrospective cohort]: Budget, revenue and expenditure data were evaluated on primary agencies and organizations (n=38), which disbursed DAH to developing countries (low- and middle-income countries as determined by the World Bank, n=146-183) for the years 1990-2014. It was found that $458 billion of DAH was disbursed with a substantial increase over time from $6.9 billion in 1990 to $35.9 billion in 2014. During the time period studied, the U.S. government disbursed 31.2% of the total, making it the greatest contributor of DAH followed by the UK government and private sources. Since 1990, maternal health/newborn and child health accounted for 28% of all DAH and HIV/AIDS for 23.2%. Between 2010 and 2012, the US government provided the majority of all HIV/AIDS DAH whereas DAH for newborn and child heath came from multiple sources. Funding for infectious diseases has ramped up since 2000, likely due to the U.S. role in funding. Funding for non-communicable diseases, however, is not reflective of the health burden these diseases have.

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