Table 4 Six priority issue areas for ODA-SDG Investment in Health

1. Health system strengthening

• “Progress in generating research evidence to support UHC has been uneven, and investment in low-income countries’ research production neglected. Currently, only 10% of health policy and systems research globally is conducted on low- and middle-income countries. Building the capacity of poorer communities to research and learn is key to their sustainable development” – Burnet Institute

• “To implement sustainable change in the Pacific health sector, long term investment is required to build the capacity of Pacific communities to implement change themselves. Investment in infrastructure to provide appropriate health facilities is essential. Critical to achieving improved health outcomes is training of clinicians, community workers and teachers, trialling and implementing customised programs, and ensuring that they continue by embedding teaching in schools and universities” – Family Planning NSW

• “[Recommendation] Scale up ODA investments in strengthening health systems to support the provision and expansion of Universal health Coverage (UHC) schemes, including the provision of high quality, comprehensive and integrated eye care services” – Fred Hollows Foundation

• “Using an inclusive approach to intervene at multiple levels of the health system with locally tailored responses to eye health workforce development increases the efficiency, suitability and sustainability of the investment by the Australian Government, provides the best chance to leave no one behind” - Vision 2020 Australia

2. Sexual and reproductive health (SRH)

• “The unmet need for family planning remains unacceptably high, especially in disadvantaged populations and in under-developed and developing countries, including in the Pacific region. In the Solomon Islands, for example, population increases are expected to outstrip food and water supply within ten years. Neighbouring Papua New Guinea is experiencing similar critical sustainability issues in relation to its current population projections. These parts of the Indo-Pacific are faced with limited and unreliable contraceptive supply, with some of the most under-resourced reproductive services in the world” - Family Planning NSW

• “We further recommend that our aid program continue to support the provision of SRH services in humanitarian emergencies and prioritise SRH support for regions where maternal mortality and the need for contraception is highest. Access to quality reproductive services has a transformative impact on women’s health, education and empowerment and is therefore essential to gender equality” - Australian Parliamentary Group on Population and Development

• “[Recommendation] The Australian Government [] increase its current funding of $23.7 million to investing $50 million per annum for reproductive health initiatives” – Global Citizen Australia

• “Sexual and reproductive health is an area of considerable success and great potential. DFAT’s Gender Equality and Empowering Women and Girls strategy recognises reproductive health as a key factor in gender equality and economic empowerment, and the Family Planning and Aid Program – Guiding Principles are supportive of comprehensive care. Family planning is a mechanisms for achieving the SDGS as it contributes to decreasing maternal and child mortality and poverty, achieving gender equality, sustainable cities, responsible consumption, decent work, and access to higher education. Family planning can also help mitigate climate change and promote sustainable communities” – Marie Stopes International Australia

3. Combatting communicable and infectious disease

• “As part of an increase in development assistance for health, Australia should focus on… Increased assistance to combat the infectious diseases claiming the most lives – HIV, TB and malaria – both through bilateral assistance in our region and through the Global Fund to Fight AIDS, TB and Malaria; Increased action to ensure all children have access to vaccines, including through ensuring the re-use of resources from the polio eradication campaign to improve vaccination systems” – Results International Australia

4. Social determinants of health, such as nutrition and food security, education, climate change & environmental health

• “Undernutrition is widespread in countries in Asia and the Pacific, in spite of their economic progress. Taking further action on nutrition would be consistent with Australia’s aid objectives of promoting sustained economic growth, improving health and education, and empowering women and girls – Results International Australia

• “The impact of under nutrition on the health, productivity and survival of individuals should be of concern for Australia given that its neighbours in the Pacific have some of the highest child undernutrition rates in the world. In particular, in Papua New Guinea (PNG) almost one in two children are stunted from undernutrition – the fourth highest child stunting rate in the world. In a ground-breaking report released in 2017, Save the Children and Frontier Economics estimated that child undernutrition cost the PNG economy a staggering $1.5 billion (8.45% of GDP) in a single year. Yet only 0.1% of Australia’s [ODA] to PNG was allocated to nutrition in the years 2010 and 2012 (latest data publicly available). It is not possible to promote inclusive and sustainable economic development in the long term in PNG if around half of the population of working age continues to suffer reduced productivity from childhood undernutrition. Indeed, child undernutrition will likely impede the potential impact of other aid investments hat bilateral and multilateral donors make for the purpose of promoting economic growth” – Save the Children

• “[Recommendation] The Australian Government should increase its support for education from 18 to 20% of the Australian aid program and increase its share of total funding for the Global Partnership for Education… In relation to Goal 3, Ensure healthy lives and promote well-being for all at all ages, achieving universal education could: Prevent seven million cases of HIV and AIDS in the next decade; enable women with at least 7 years of formal education to have two or three fewer children; and reduce child mortality rates” – Results International Australia

• [Recommendation] The Australian Government to increase its support for education and increase its share of total funding for the Global Partnership for Education from current investment of $900 million to $200 million AUD” - Global Citizen Australia

• “[Recommendations] Australia should increase its contribution to international climate finance as part of a growing aid program and in line with Australia’ international obligations; Australia should develop a comprehensive Climate Change Strategy for the aid program” – Oxfam Australia

• “As our closest neighbours in the Pacific are among those most vulnerable to climate change and associated health impacts, Australia should be positioning itself to work on all SDGs in ODA but with a focus in the region on climate change, clean energy, land and ocean use, and chronic diseases and gender equality” – Doctors for the Environment Australia

5. Eye health

• “[Recommends] “Eye health and vision care is regarded as a public health priority in Asia and the Pacific” – Vision 2020 Australia

• “Good vision transforms lives and has positive development impacts far beyond good health; it can enable individuals and families to pull themselves out of poverty, helps people to go back to work or school, and to overcome inequality, marginalisation and exclusion that blindness and vision loss often perpetuate” – Fred Hollows Foundation

6. Health security

• “DFAT engagement that aligns with SDGs 3, 5, 16 and 17[:] Australia’s Foreign Policy White Paper highlights our commitment to guarding against global health risks, in particular preventing and responding to the introduction and spread of infectious diseases. The Minister for Foreign Affairs recently launched the Indo-Pacific Health Security Initiative ($300 million, 2017–22), which will support efforts to prevent and contain disease outbreaks in the Indo-Pacific that have the potential to cause social and economic impacts on a national, regional or global scale. Complementary to this initiative, Australia’s ODA program supports countries to build strong, functioning health systems, which are critical to promoting sustainability and achieving sustainable economic growth” – Department of Foreign Affairs and Trade (DFAT)

• “The new Indo-Pacific Centre for Health Security is a very welcome initiative and a clear opportunity for Australian ODA to support progress in areas of health and wellbeing (SDG 3), both short-term through infectious disease and biosecurity and in the long-term by addressing drivers of risky behaviour at the individual, household, community, national and regional levels” – University of Sydney