Following the debate
which took place during the sitting of 11 March 2009, the European Parliament
adopted by 555 votes to 8 with 11 abstentions, a resolution tabled by the
Committee on Development on an approach to "EC development assistance to
health services in sub-Saharan Africa".
Parliament
began by noting that EC funding for the health sector has not increased as a
proportion of its total development assistance since 2000 despite the
Commission's commitment to the MDGs and the health crisis in sub-Saharan Africa. It considers that weak health systems, including the human resources crisis, are a
major barrier to the achievement of the health-related MDGs, and stresses
that strengthening health systems should be an essential element in poverty
reduction. Basic healthcare infrastructure needs stable, long-term financial
support if the health-related MDGs are to be delivered.
Members feel
that, with a view to reaching better health outcomes, a common commitment is
needed. They welcome the commitment on the part of the developing countries
to work towards the target of 15 % of national budgets as investment for
health in accordance with the commitments made by African leaders in Abuja,
Nigeria, in April 2001. They regret, however, that the EC allocated only 5.5
% of total assistance under the 9th European Development Fund (EDF) to
health. Parliament urges the Commission to strengthen its support for health
services in sub-Saharan Africa and to review the balance of the EC funding
with a view to prioritising health system support. The Commission needs to
increase the funds allocated to the health sector at the mid-term review of
the 10th EDF, regardless of a comprehensive strategy which includes support
to sectors that have a wider impact on health outcomes, such as education,
water and sanitation, rural development and governance.
The
undertaking given in the context of the Development Cooperation Instrument
(DCI) to devote 20% of funds to health and basic education by 2009 should
apply to all European development policy spending, including the EDF, in
order to be coherent.
Members asked
the Commission to do the following:
- to ensure
that there is sufficient health expertise to play an effective role in
the health sector dialogue by seeing to it that all delegations where health
is a focal sector have health specialists, by working more closely in
post-conflict countries with European Community Humanitarian Aid
department (ECHO) health advisers, by forming closer partnerships with
the WHO, and by entering into formal agreements with Member States to
use their expertise. Parliament wants detailed information on health and
education experts;
- to provide
technical assistance support to the Global Fund to Fight AIDS, Tuberculosis
and Malaria (GFATM) at country level in the preparation of grant
applications and in the implementation of grant contracts and to provide
feedback to EC headquarters in order to ensure that it plays an
effective role on the GFATM's executive board;
- a greater
prioritisation of easily preventable diseases, such as diarrhoeal
diseases, which could be largely avoided;
- to make
greater use of general budget support for strengthening healthcare with
performance indicators of progress towards the Abuja 15% target and
execution rates, technical assistance on health-sector policy dialogue
and sound statistical systems;
- to ensure
that MDG contracts concentrate primarily on the health and education
sectors and to develop alternative approaches, for those countries not
yet eligible for MDG contracting, which are often further away from
achieving the health MDGs;
- to use
targets that directly measure the outcome of policies and to put in
place mechanisms to ensure that an adequate proportion of general budget
support aid supports basic needs, particularly in health;
- to make
greater use of sector budget support, and to review the general
requirement that sector budget support can only be used if health is a
focal sector and to reconsider its current distribution of resources
between sector budget support and general budget support;
- to provide
support for scrutiny of budget support by parliaments, civil society and
local authorities in order to ensure a strong link between budget
support aid and the achievement of the MDGs;
- to encourage
countries to increase national health budgets through the use of
performance indicators by targeting such increases in its general Budget
Support Financing Agreements. Parliament deplores the fact that only in
6 partner countries was health selected as a focal sector under the
tenth EDF;
- to
disseminate clear guidance on when each of the instruments should be
utilised and how they can be used in combination to maximise synergy,
and to ensure coherence between the different financial instruments.
Lastly,
Parliament insists that the Commission and the Member States apply the EU
Code of Conduct on Division of Labour Development Cooperation to ensure that
health spending and programmes are better coordinated and to ensure a sharper
focus on neglected aid-orphan countries, including countries in crisis and
fragile states.