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Domestic resources increase as external funding goes off-budget - P4H Network

Domestic resources increase as external funding goes off-budget

Execution of domestic resources for health has increased significantly in recent years in nominal terms, according to new Budget Execution Report (BER) 2018 issued on Feb.2019. It now stands at 307 MUSD, while in 2017 the execution was 248 M USD. This data refers strictly to funds allocated by the Treasury.

Funds under public management have reached 403 M USD in 2018, compared to 364 MUSD in 2017. These amounts include funds that use national systems (on-CUT/Single Treasury Account), in kind donations, and development assistance that not necessary flows though national systems, but with is inscribed and reported.External funding has accounted for 23,8% of total funds managed by the Ministry of Health. This percentage reached 52% in 2013 and has steadily decreased since then, even with the start of the GFF in 2018.

While this data show a lower level of external dependence, this path is mainly due to reduction of external funding through national systems. The Basket Fund Pro-Saúde reached 120 MUSD in 2012 and now it provides only 17 MUSD. Donors have a renewed preference for bilateral programs, technical assistance, and off-budget support, including vertical funding.

Estimates of the off-budget funding, thus not recorded in the BER, suggest that global external funding could continue to account for around 55% of the total funding of the health sector, with would mean no real reduction in external dependency, especially for disease-specific programmes and drugs.