"Show me the money"

03 May 2012

“The UN Summit changed the way we considered NCDs as a poverty and development issue”. 
That was what I heard two weeks ago during a panel I was speaking on at the University of Sydney. You may say that this is nothing new – that opinion leaders in global health were saying this straight after the Summit. True. But what was different was that it wasn’t an expert from our own NCD inner circle. It was a representative from a development aid agency – AusAID– who said these important words.

We as a community have failed to convince the development aristocracy and its agencies to fund NCDs in low-income countries

They are important words because as a general rule, we as a community have failed to convince the development aristocracy and its agencies to fund NCDs in low-income countries. Just take Official Development Assistance (ODA) spending on health as an example. NCDs account for 60% of the global burden, yet a mere 3% of the $22 billion spent on health goes to NCDs. Why this measly aid spending? Because of outdated and skewed development and aid policies that remain stubbornly tied to health priorities in the Millennium Development Goals (MDGs), rather than responding to the actual needs and priorities of developing countries. And this trend can be seen both in the policies of individual bilateral aid agencies, as well as the Organisation for Economic Co-operation and Development (OECD), the convening club of donors, which heavily influences aid policy.  

We need champions like AusAid to put pressure on other bilateral aid agencies to shift their policy

It was therefore refreshing to hear an influential bilateral donor like AusAid take a strong position for funding of NCDs. By funding retinopathy and diabetes screening programmes in the Pacific Islands, AusAid are clearly ahead of the field. And it was encouraging that they viewed the Summit as an important turning point in their thinking. But as I said during the seminar, we need to see more development agencies taking up the mantle of NCDs.

How do we make this happen? We need champions like AusAid to put pressure on other bilateral aid agencies to shift their policy. We in civil society need to hold the OECD and its members to account on their promises in the Paris Declaration on Aid Effectiveness, to support the priorities of recipient governments. And we need our member associations and NCD NGOs in recipient countries to be involved in planning and consultations for development aid at country level.

We need to ask one simple question - why is it not possible to allocate sufficient money to prevent and control diabetes?

But above all, we must not allow political leadership and the development aristocracy to use the excuse of the global financial crisis to compromise the health of millions. We’re talking about real lives here and the future of humanity. We need to ask one simple question - why is it not possible to allocate sufficient money to prevent and control diabetes? By preventing and controlling diabetes and the other NCDs we would actually speed up progress towards achievement of the Millennium Development Goals by 2015. By investing upfront in diabetes prevention and control we can guarantee savings not only in human lives and misery but also in dollars spent on costly avoidable complications. And the cost would be just a fraction, a miniscule fraction, of all the public dollars that were used to bail out the banks or that even some resource poor countries spend on armaments.

Together, we need to catalyse a change in thinking on development and aid policy, and close the global funding gap for diabetes and NCDs. The UN Summit provided the wake up call. And now the UN Conference on Sustainable Development (Rio+20) and the process to define the post-2015 development agenda provide the impetus for action.