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Paper short abstract

Global health aid landscape is rapidly changing, presenting an opportunity for small yet stable donors (in absolute funding) to have a relatively disproportionate influence given their continued support. The paper describes key structural characteristics of their aid to countries and multilaterals.

Paper long abstract

For many low- and middle- income countries (LMICs), progress towards the Sustainable Development Goals (SDGs) has stalled. Crises, including COVID-19 pandemic, conflicts and climate change, have increased the need for Official Development Assistance (ODA). However, the financing gap is widening, largely driven by decisions from several large bilateral donor countries (notably the USA, United Kingdom and France) to reduce ODA commitments. This important change in the global aid landscape threatens to reverse hard-won gains in key sectors such as global health, further compromising progress towards the SDGs.

Despite this trend, smaller bilateral donors such as Luxembourg, Austria, Iceland, Ireland and New Zealand have committed to maintaining or increasing their aid in the next three-to-five year period. Though their ODA contributions are small in absolute terms (each providing less than three billion USD annually), the design and delivery of their aid has been independently assessed as high-quality, promoting principles of aid effectiveness such as ownership and transparency in their engagement with recipient countries and multilateral organisations. This emerging core donor segment referred to in this proposal as ‘small yet stable donors' could drive large influence in health agenda setting, implementation, and contribute to greater health impacts in the new aid landscape.

This paper aims to assess the key structural characteristics of health aid that this group of donors provide, using a mixed-methods approach of quantitative descriptive analysis and qualitative interviews. It will also assess whether their aid aligns with the key aid effectiveness principles and how it compares to larger donors.