1. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Regional consultation meeting Harmonization and Alignment of Cooperation in Middle-income Countries Dr. Juan Manuel Sotelo Pan American Health Organization (PAHO/WHO) Integrated health services networks and vertical programs: Maximizing synergies for collaborative work Cuzco, Peru 11-12 November 2009

2. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Actors in International Cooperation on Health GOVERNMENTAL ASSISTANCE NON-GOVERNMENTAL ASSISTANCE OFFICIAL AGENCY Bilateral Path

3. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships ODA of OECD members, 1990-2010 0.33 Source: OECD database ODE as % of GDP

4. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships 0.33 0.22 ODA of OECD members, 1990-2010 ODA as % of GDP Source: OECD database

5. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships 0.33 0.22 ODA as % of GDP ODA of OECD members, 1990-2010 Source: OECD database

6. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships 0.33 0.22 0.33 Total ODA ODA as % of GDP ODA of OECD members, 1990-2010 Source: OECD database

7. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships 0.33 0.22 0.28 0.33 Total ODA ODA as % of GDP ODA of OECD members, 1990-2010 Source: OECD database

8. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships 0.33 0.22 0.28 0.35 0.33 Increase required to achieve goals by 2010 ODA as % of GNI Total ODA ODA of OECD members, 1990-2010 Source: OECD database

9. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Latin America in the global context Latin America has lost a share of ODA. In the past two years, ODA to the region has registered the lowest levels of the decade as a percentage of total ODA to developing countries. In per capita terms, Latin America receives one-third of what Eastern Europe or sub-Saharan Africa receives. ODA by world region 2005 – 2007 - 5 000 10 000 15 000 20 000 25 000 30 000 35 000 40 000 45 000 50 000 AFRICA AMERICA ASIA EUROPE OCEANIA USD Million 2005 2006 2007 ODA to Latin America and the Caribbean in % 0.0 2.0 4.0 6.0 8.0 10.0 12.0 20032004200520062007 Year %

10. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Latin America and the Caribbean, HDI 2007 Source: PAHO with data of UNDP

11. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Health aid, by source, 2007 Source Cooperation on health Channel Government 65.7% US$ 14,322 million Private sources 26.7% US$ 5,814 million Debt forgiveness 1.8% US$ 398 million Other and unclassified 5.8% US$ 1,253 million Bilateral agencies 34% US$ 7,398 million Development Banks 7.2% US$ 1,575 million UN agencies 14% US$ 3,059 million European Commission 2.4% US$ 521 million Global Partnerships on Health 12.5% US$ 2,718 million Philanthropic foundations 5.2% US$ 1,143 million NGOs 24.7% US$ 5,375 million International cooperation on health 100% US$º 21,788 million Source: Author, with Health Metrics and Evaluation data, University of Washington.

12. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Changes in international health aid, 1990-2007, LAC Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington 0 200 400 600 800 1000 1200 1400 1600 199019911992199319941995199619971998199920002001200220032004200520062007 USD Million

13. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Health aid by subregion in Latin America and the Caribbean, 1990-2007 Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington 0.00 200.00 400.00 600.00 800.00 1000.00 1200.00 1400.00 1600.00 199019911992199319941995199619971998199920002001200220032004200520062007 USD Million Caribbean MERCOSUR Andean Central America

14. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Health aid by subregion in Latin America and the Caribbean, 1990-2007 Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington

15. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington 0.00 100.00 200.00 300.00 400.00 500.00 600.00 700.00 1990-19911992-19931994-19951996-19971998-19992000-20012002-20032004-20052006-2007 Biennia USD Million Colombia Bolivia Peru Ecuador Chile

16. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington 0.00 20.00 40.00 60.00 80.00 100.00 120.00 140.00 160.00 1990-19911992-19931994-19951996-19971998-19992000-20012002-20032004-20052006-2007 USD Millilon Nicaragua Honduras Guatemala Dominican Republic El Salvador

17. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington 0.00 50.00 100.00 150.00 200.00 250.00 300.00 350.00 400.00 450.00 500.00 1990-19911992-19931994-19951996-19971998-19992000-20012002-20032004-20052006-2007 USD Million Argentina Brazil Paraguay Uruguay Venezuela

18. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington 0.00 10.00 20.00 30.00 40.00 50.00 60.00 1990-19911992-19931994-19951996-19971998-19992000-20012002-20032004-20052006-2007 USD Million Guyana Cuba Jamaica Suriname St. Helena Belize

19. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Health aid in Latin American and Caribbean countries, 2007 Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington

20. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships Per capita health aid in Latin American and Caribbean countries, 2007 Source: PAHO with data from the Institute for Health Metrics and Evaluation. University of Washington

21. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships What do we mean by “aid effectiveness”?

22. WORLD CRISIS : Its impact on health cooperation External relations, mobilization of resources, and partnerships