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p. 9 of 27 BACK | NEXT Executive summary Introduction Regional health context Health status Major trends in the health sector Financing of health services Global commitments to the health sector The Bank’s involvementin the health sector Issues and options The Bank’s health policy

Policy for the Health Sector : Regional health context

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Global commitments to the health sector

At a series of international conferences, world leaders have affirmed that universal access to basic health services is a critical aspect of social development and poverty reduction. Quantifiable and time-bound targets were established and endorsed by the World Health Assembly in 1978, the World Summit for Children in 1990, the International Conference on Nutrition in 1992, the International Conference on Population and Development at Cairo in 1994, the World Summit for Social Development at Copenhagen in 1995, and the Fourth World Conference on Women at Beijing in 1995. (Examples of these targets are a one-third reduction in under-five mortality rates, and the achievement of 90 percent immunization coverage by the year 2000.) The targets endorsed by these conferences and summits represent an international commitment to the provision of basic health services, including family planning, reproductive health, and nutrition, to all people. Beginning with the Cairo and Copenhagen conferences, the international community called on developing countries and their partners to translate their commitments to the specific targets into “a mutual commitment between interested developed and developing country partners to allocate, on average, 20 percent of official development assistance (ODA) and 20 percent of the national budgets, respectively, to basic social programs.”¹⁶ This 20/20 commitment, as it came to be called, defines basic social services as basic health, including reproductive health, population, and nutrition; primary education, including early childhood development and basic education for youth and adults; and environmental health comprising low-cost water supply technologies and low-cost sanitation.

While total ODA from OECD members has declined over recent years both as a percentage of GDP and in constant dollars, the situation in health is a little less clear. From the mid-1980s until 1991, there was a real decline in aid for the health sector; however, since that time, the amount dedicated to health appears to be increasing but has not returned to mid-1980s levels in real terms. While the data do not allow for an analysis of external assistance to the health sector in the Bank’s DMCs, overall ODA for the Asian and Pacific region is less than what it was in the mid-1980’s. In sum, the available data suggest that ODA for health in the DMCs is lower in real terms than it was 10 years ago and is unlikely to rise appreciably in the next few years.

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