Seite 1 BMZ Health Sector Strategy (Health Division) Framework, principles and thematic areas of German Development Aid for Health Dr A Stadler – Senior Advisor GTZ Health Section February 2009

Seite 2 Introduction BMZ Health Sector Strategy: Conceptual framework for the German Development Aid for Health Framework for programme and project type support Guidelines for cooperation with partner countries and organisations Information tools for the public

Seite 3 Introduction (2) Health is mainly determined by: Effective preventive and curative health services, health promotion, and rehabilitation Healthy living conditions, such as water, housing, nutrition, education Peace, security and social and economic equity The current BMZ Health Sector Strategy deals mainly with elements related to health promotion and health services

Seite 4 Health Systems All organizations, institutions and resources in a country dealing with health Public and private sector Promotional, preventive, curative and rehabilitative measures

Seite 5 Health Systems (2) Services to be needs-orientated, equally distributed (coverage) and accessible for all Performance depends on –available resources (finance, human resources and infrastructure) –governance (respect of human rights, corruption, rights of beneficiaries, support)

Seite 6 Some Essential Components of Primary Health Care (PHC) Equitable distribution Community participation Inter-sectoral cooperation Appropriate technology Availability of support mechanisms

Seite 7 Main thematic areas of BMZ Strategy Health System Strengthening: Decentralised organization, respect of good governance principles and human rights Sustainable health system financing and social protection in health Capacity development for planning and management, training and research Human resources for health Infrastructure and technologies

Seite 8 Main thematic areas of BMZ Strategy (2) Health System Strengthening (2): Poverty alleviation through extension of PHC coverage Quality and equity through support to different levels of health system organization - Focus on “horizontal” approaches and on the “district health concept”

Seite 9 Main thematic areas of BMZ Strategy (3) Disease Control: Support to specific or disease targeted actions via national (bilateral) or via global (multilateral) programmes Vertical organization only if appropriate, focus on integration / systemic approach AIDS, Malaria, Polio and other Neglected Diseases Support to research (but mainly through other Ministries)

Seite 10 Main thematic areas of BMZ Strategy (4) Fight against HIV/AIDS (cross-cutting issue): Special focus of German development aid Disease control (prevention, diagnostic, treatment, research) Social and psychological support Target group specific activities with focus on protection of women and children Mainstreaming HIV into all relevant sectors of German Development Cooperation

Seite 11 Main thematic areas of BMZ Strategy (5) Sexual and Reproductive Health and Rights: Special focus of German development aid Family planning, prevention of STI Safe motherhood (including safe abortions) Empowerment of young women and girls / sexual education Activities related to harm reduction and post- care (including FGM) Mainstreaming SRHR into all relevant sectors of German Development Cooperation

Seite 12 Core Principles “Health as a Human Right” based approach: Core elements of this approach: –Equity in access to and quality of Health services Health information Healthy living conditions for poor and other marginalised groups –Essential part of poverty reduction strategy BMZ supports health system approaches focussing on these core elements Governments have the duty to enable the right to health for their people

Seite 13 Instruments for Implementation (1) Bilateral Instruments: Financial Cooperation Technical Cooperation –Technical Assistance –Temporary Staff Secondments / Substitution –Voluntary Service (Public, Faith-based organizations) –Capacity Development (Universities, Development Agencies, Private Sector…)

Seite 14 Instruments for Implementation (2) Multilateral Instruments: Financial support to international organizations and Global Health Institutions and Initiatives (e.g. IHP, P4H) Support of DAC-Criteria like: Increase of PBA, SWAp-support, Sectoral and General Budget Support, Basket support, Pooling arrangements

Seite 15 Strategies for Implementation (1) Cross-Cutting Approaches: Health as Human Right Focus on inter-sectoral cooperation and mainstreaming of health related activities (e.g. HIV/AIDS, Health of Children, SRHR) into other sectors (e.g. water, education, civil sector development, decentralisation) PHC strategy as essential part of health system development including disease control aspects Private Sector Support: Activities implemented through NGOs and faith-based organizations Activities implemented and co-financed through private business (PPP)

Seite 16 Facts and figures on German Cooperation in Health (1) Actually 17 priority countries of cooperation in the health sector – 7 in SSA Health related activities in about 58 countries – 21 in SSA Major input on different aspects and different levels of health system strengthening in about 30 countries – 15 in SSA –But health system strengthening and PHC part of almost all integrated approaches (including those with a focus on HIV/AIDS, SRHR or Social Protection)

Seite 17 Facts and figures on German Cooperation in Health (2) Development of the German Bilateral ODA in Health (in Million Euro) * without HIV/AIDS, SRHR and Social Protection Total7208,96890,36827,0 Social Infrastructure and Services 1985,9 (27,5%) 2250,6 (32,7%) 2399,0 (35,1%) Health* Basic Health Systems / PHC 117,5 68,6 131,3 67,5 156,3 93,6

Seite 18 Thank you!