Mind the Gap

Since the millennium, significant progress has been made in tackling global poverty. The number of people living in extreme poverty has fallen by an impressive 50% and the number of Low Income Countries has reduced from 63 in 2000 to 31 in 2016.

But economic growth hides increasing inequality, particularly in access to health services. For example, despite being the richest country in Africa, less than half of Nigeria’s children have been vaccinated. And India, one of the world’s largest economies, has the highest rates of malnutrition in the world - just under 15% of the population goes to bed hungry. 70% of people living in extreme poverty now reside in Middle Income Countries.

As more and more countries move from low to middle-income status, donors are starting to change their relationships with them, moving from a focus on providing aid, to closer economic or diplomatic relations. But when countries achieve middle-income status, they also start to lose eligibility for financial support. If done too fast and in an uncoordinated way, this withdrawal of funding poses a huge risk to the health of millions of people as many countries will increasingly have to fund their health systems from scarce domestic resources.

The impact of donor withdrawal is already being felt in some countries with high TB burdens in Eastern Europe and Central Asia. In Romania, funding from the Global Fund to Fight AIDS, TB and Malaria will end in 2018.  And as we edge closer to the eradication of polio, money to support efforts to eradicate the disease that also help pay for the delivery of other vital health services will shortly be withdrawn. As a result, many countries will become more vulnerable to epidemics and outbreaks of diseases like measles and diphtheria.

In order to achieve the Global Goals by 2030, the Department for International Development’s policies must focus on coordinated and sustainable transition, to help manage these changing aid relationships in a responsible and gradual way.

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