1. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 1 AID EFFECTIVENESS FOR HEALTH TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011

2. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 2 Main Messages Health provides unique insights and lessons into the complexities of aid architecture Effective aid creates conditions for success There have been significant achievements in the health sector There are still significant challenges and risks in the health sector Lessons from the health sector

3. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 3 Health provides unique insights and lessons into the complexities of aid architecture

4. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 4 Health provides unique insights and lessons into the complexities of aid architecture

5. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 5 Health provides unique insights and lessons into the complexities of aid architecture

6. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 6 Health provides unique insights and lessons into the complexities of aid architecture Too many cooks?

7. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 7 Health provides unique insights and lessons into the complexities of aid architecture 7

8. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 8 Effective aid creates conditions for success Which successes? – Health system development Better sector planning, budgeting and governance Strengthened national health systems – Better health outcomes Polio Eradication AIDS epidemic under control Decreased vaccine preventable deaths Decreased malaria mortality TB Control

9. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 9 Effective aid creates conditions for success Tension and challenges: striking the right balance – Finding better complementarities between: programmes that score well on delivering shorter term measurable results, though often at the expense of aid effectiveness and longer term transformational change, and whole-of-sector approaches that are more sustainable, focus on greater alignment with country needs, institutions and priorities, but are more challenging to measure and report Using health as a “tracer” sector has deepened understanding of the risks and benefits of diversity and has leveraged action for a more coordinated and coherent approach to the global aid architecture

10. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 10 There have been significant achievements in the health sector Efforts to improve aid effectiveness in health has led to a shift in how donors and partner countries engage – from a focus on delivering on discreet projects and activities – to a strategic developmental discourse This shift in approach is central for "development effectiveness"

11. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 11 There have been significant achievements in the health sector Good progress in implementing the Paris principles – strengthening country ownership (+ country systems) CSOs, private sector, Parliament – Alignment, harmonisation, division of labour and implementation of common arrangements are improving Global health programmes? – Dialogue and information sharing between donors and countries – Donors have made systematic efforts to improve aid predictability

12. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 12 There are still significant challenges and risks in the health sector There is a significant ‘disconnect’ between global commitments and country level practices – a significant proportion of aid for health is still ‘off budget’, – increase in aid for health is not matched by a commensurate increase in use of budget support – aid remains highly unpredictable – countries have also not consistently met commitments, (Abuja target) – strengthening country systems (i.e. PFM) systems depends on wider government reform – Demonstrating the impact of aid effectiveness on health outcomes is challenging – The transaction costs of aid effectiveness processes are high,

13. TITLE from VIEW and SLIDE MASTER | 27 July 2006 AID EFFECTIVENESS FOR HEALTH: TOWARDS THE 4TH HIGH-LEVEL FORUM, BUSAN 2011 13 Lessons from the health sector In for the long haul: Set realistic expectations about what can be achieved and when Context and politics matter : Genuine and sustainable changes in donor and country behaviour is as much about country context and politics as it is about technical fixes and changing aid modalities. The Paris principles are a means to an end Concentrate efforts on those principles with greatest potential for development– aligning with national priorities and providing predictable, sustained and on-budget aid. Don’t reinvent the wheel: Existing health sector compacts, codes of conduct, tools and accountability can be adapted and used for other sectors. Think twice: Avoid establishing new global funds and programmes (duplication, competition, fragmentation). Country problems solutions must be based on a clear analysis of the existing global and national institutional context. Plan for measuring results since the start: Invest early on in developing a common understanding and expectation of results and in regular, robust, independent monitoring and evaluation of aid effectiveness processes and impact.