a great past, a greater future - advance family …...advance family planning 3 number of advocacy...

A Great Past, A Greater FutureDuff GillespieTuesday 09 April 2019

AFP’s Past Success

Advance Family Planning 3

Number of Advocacy Wins Continues to Rise, to a Record 445 in Year 6

1. Most of AFP’s advocacy wins (56%) since 2009 were budget wins.2. The vast majority of the 1,315 advocacy wins (89%) were achieved at the subnational level.3. Even though in year 6, AFP partners scaled back engagement at the subnational level, the number of

advocacy wins continued to increase.

13

133

1166

GLOBAL/REGIONAL

NATIONAL

SUBNATIONAL

94

480

738

VISIBILITY

POLICY

BUDGET

Since 2009:

39115

305411 445

1315

0

200

400

600

800

1000

1200

1400

AFP 1 (2009-12) PY 1-3 (2012-15) PY 4 (2015-16) PY 5 (2016-17) PY 6 (2017-18)* TOTAL

Budget Policy Visibility


Investments in Family Planning Increased in AFP Geographies

In 2017-2018:1. 361 governments and 4 corporations allocated $25.8 million for family planning, a

35% increase from the previous year.a. $304,698 in new, first-time allocations for family planning

2. 143 geographies made repeat allocations for 2+ consecutive years3. 67 geographies sustained the same level of funding or increased funding

$0

$5

$10

$15

$20

$25

$30

PY 2012-13 PY 2013-14 PY 2014-15 PY 2015-16 PY 2016-17 PY 2017-18Subnational $2,713,259 $3,514,762 $868,777 $4,732,743 $7,467,704 $8,066,915National $1,824,690 $2,710,377 $1,889,958 $7,189,843 $11,740,704 $17,790,927

Fam

ily p

lann

ing

budg

et

allo

catio

ns(in

milli

ons,

US

$)

361 government units

11 government units

Challenges To Local Ownership


ODA Disbursements for Health, 2002-2013

$4.4 $5.8

$7.1

$9.4 $10.9

$13.5 $15.4

$17.0 $18.4

$19.6 $20.1

$22.8

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

CurrentConstant (2013$)

US$ Billions

NOTES: Amounts in gross US$ disbursements. Health ODA combines data from three OECD CRS sub-sectors: (1) Health; (2) Population Policies/Programs and Reproductive Health (includes HIV/AIDS & STDs); and (3) Other Social Infrastructure and Services - Social Mitigation of HIV/AIDS. SOURCE: Analysis of data obtained via online query of the OECD Development Assistance Committee (DAC) Database and Creditor Reporting System (CRS); September 14, 2015.


Major Sub-Sector Share of Health ODA, 2002 & 2013

Health Management & Workforce

23.4%Basic Health & Infrastructure

21.7%

FP/RH19.4%

HIV/AIDS19.1%

Other Infectious Diseases

12.5%

Nutrition2.4%

Research0.6%

Malaria0.6%

TB0.3%

2002

Total = $4.4 billion

HIV/AIDS35.3%

Basic Health & Infrastructure

19.2%

FP/RH12.6%

Malaria8.6%

Health Management &

Workforce8.0%

Other Infectious Diseases

5.9%

TB4.8%

Nutrition4.1%

Research1.5%

2013

Total = $22.8 billionNOTES: Amounts in gross US$ disbursements. Health ODA combines data from three OECD CRS sub-sectors: (1) Health; (2) Population Policies/Programs and Reproductive Health (includes HIV/AIDS & STDs); and (3) Other Social Infrastructure and Services - Social Mitigation of HIV/AIDS. SOURCE: Analysis of data obtained via online query of the OECD Development Assistance Committee (DAC) Database and Creditor Reporting System (CRS); September 14, 2015.


Donor Government Disbursements for HIV, 2002-2017

$1.2$1.6

$2.8

$3.5$3.9

$5.0

$7.8 $7.7

$6.9

$7.6 $7.9

$8.5 $8.6

$7.4$7.0

$8.1

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Current

Constant (2014$)

US$ Billions

SOURCES: UNAIDS and Kaiser Family Foundation analyses; Global Fund to Fight AIDS, Tuberculosis and Malaria online data queries; UNITAID Annual Reports and direct communication; OECD CRS online data queries.


U.S. Funding for Global Health and International FP/RH has Stagnated

$10.3 $10.0 $10.1 $9.8$10.5

$11.3$10.6 $10.7

$8.1

$0.0

$2.0

$4.0

$6.0

$8.0

$10.0

$12.0

2010 2011 2012 2013 2014 2015 2016 2017 2018 request

Glob

al H

ealth

fund

ing

(bill

ions

of U

SD)

Fiscal YearSource: Kaiser Family Foundation. US Global Health Budget: Overview. November 2017


Donor Government Bilateral Assistance

for Family Planning, 2012-2017

$1.09

$1.33 $1.43

$1.34 $1.20 $1.27

2012 2013 2014 2015 2016 2017

CurrentConstant (2014$)

SOURCE: Kaiser Family Foundation analyses of data from donor governments and OECD CRS database.


Donor Governments as a Share of Total

Bilateral Disbursements for Family Planning,

2017

U.S.38.4%

U.K.22.2%

Netherlands15.5% Sweden

8.6%

Canada5.4%

Germany2.9%

Denmark2.6%

Australia2.0%

France1.5%

Other DAC Countries

0.7%

Norway0.2%

NOTE: Based on current US$.

SOURCE: Kaiser Family Foundation analyses of data from donor governments and OECD CRS database.

$1,272.7 millionBilateral Disbursements

Senate 50-50

House

Bush ClintonReagan GW Bush

100

200

300

400

500

600

700

800

Fund

ing

(mill

ions

US$

)

RequestedApproved

Obama

U.S. Population Funds: A Brief Case StudyRevised 25 March 2019

Global Gag Rule Imposed

Global Gag Rule Rescinded

Trump

No FY2018 budget request


Health Spending, by Country and Source, 2014

Source: Dieleman, J. et al. (2017) Evolution and patterns of global health financing 1995–2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet 2017. Published Online April 19, 2017 http://dx.doi.org/10.1016/S0140-6736(17)30874-7

Country Total health expenditureper GDP

Domesticgovernment health spending*

Prepaidprivate spending*

Out-of-pocketspending*

Development assistancefor health*

Bangladesh 2.9% 22.7% 0.0% 65.6% 11.7%

DRC 4.5% 21.3% 0.0% 37.4% 41.3%

India 4.5% 31.3% 2.4% 65.6% 0.7%

Indonesia 2.5% 42.7% 2.7% 53.5% 1.1%

Kenya 6.4% 37.8% 3.8% 23.4% 35.0%

Nigeria 3.7% 22.1% 0.8% 70.1% 7.0%

Tanzania 6.4% 20.3% 17.1% 20.2% 42.4%

Uganda 18.1% 0.9% 64.8% 16.4% 18.0%*Per total health spending


Who Pays for Family Planning


Rising Nationalism

Opportunities For Scale Up


AFP Increased Its Geographic Reach

>16 fold increase in population potentially benefiting from AFP advocacy, since 2013>6 fold increase in the # of AFP subnational geographies

050100150200250300350400450

0

20

40

60

80

100

120

140

PY2 (13-14) PY3 (14-15) PY4 (15-16) PY5 (16-17) PY6 (17-18)

# AF

P su

bnat

iona

l ge

ogra

phie

s

# W

RA

pote

ntia

lly re

ache

d by

AFP

adv

ocac

yM

illion

s

Subnational WRA Subnational geographies

7 million WRA53 subnational

geographies

128 million WRA411 subnational

geographies


Scaling Up Advocacy Globally by Mainstreaming AFP SMART Advocacy

6 Mainstreaming INGOs

148 country offices in 81 countries

17,980 employees

$1.2 billion budget (combined)

Jhpiego

Pathfinder

Population Council

Marie Stopes International

Center for Communication Programs

Amref


AFP Timeline Of Activities

Portfolio Refresh

Dashboard Launch

White Paper Launch

Ongoing AFP Advocacy Activities

Mainstreaming Workshops

White Paper Convenings

AprNov 2018 –Mar 2019

May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarPY7 Q3Present

AprPY7 Q4 PY8 Q1 PY8 Q2


Ongoing Priorities

1. Budgets2. Task sharing3. DMPA-SC4. Postpartum Family Planning5. Youth6. Quality7. Transition to Sustainability8. Ouagadougou Partnership Regional Effort

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