Rishita Nandagiri, Joe Strong, Tiziana Leone and Ernestina Coast explain why recent cuts to global health funding by the UK are devastating for certain countries and groups, while they also create a dangerous vacuum into which ‘philanthrocapitalists’ and private foundations will step, allowing them to set global development agendas without any political mandate

Coast, Ernestina

Leone, Tiziana

Nandagiri, Rishita

Strong, Joe

English

LSE Research Online

LSE British Politics and Policy May 26th, 2021Recent UK cuts to global health funding will cause irrevocabledamage under the guise of ‘tough but necessary decisions’0 comments | 12 sharesEstimated reading time: 10 minutesRishita Nandagiri, Joe Strong, Tiziana Leone and Ernestina Coast explain why recentcuts to global health funding by the UK are devastating for certain countries and groups,while they also create a dangerous vacuum into which ‘philanthrocapitalists’ and privatefoundations will step, allowing them to set global development agendas without anypolitical mandate.In 2020, the government announced the merger of the Department for InternationalDevelopment (DfID) and the Foreign and Commonwealth O ce (FCO) into the newForeign, Commonwealth, and Development O ce (FCDO), signalling a stark change indirection of UK o cial development assistance (ODA). This was followed by anannouncement about the government missing its legally mandated target of spending0.7% of GNI on ODA, instead only spending 0.5%. Blaming the economic impact of thepandemic, the government insisted spending would return to 0.7% ‘when the  scalsituation allows’. Analyses show these cuts are likely to have almost insigni cantimpacts for the UK economy.Previously the second-largest government donor in global health and professing acontinued commitment to ‘improve global health’, the UK has cut funding for polioeradication by 95% and for water, sanitation and hygiene by more than 80%. It has alsohalved its commitment to a human rights programme, reduced a health workers’ trainingscheme by £48 million, and abruptly stopped payments which have affected ambulanceand referral services in Sierra Leone; maternal and neonatal health in Somaliland; andoperating theatres in the Democratic Republic of Congo. Cuts to programmes in Syriaand Yemen, amongst others, raised concerns about increased hunger and malnutrition;stunting children’s health and development. Dominic Raab, the Foreign Secretary,extolled the UK’s commitment to girls’ education at the recent G7 summit, despiteoverseeing funding cuts of nearly 40%. The full extent of cuts and programmes affectedremains unclear as new announcements and leaks come to light.UK funding for UNAIDS was slashed by 83%, and for UNFPA by 85%. UNFPA estimatesthat the ‘[…] now-withdrawn 130 million GBP (180 million USD)… would have helpedprevent around 250,000 maternal and child deaths, 14.6 million unintended pregnanciesand 4.3 million unsafe abortions’. This comes alongside severely restricting the UK’s agship Women’s Integrated Sexual Health (WISH) programme on sexual andreproductive health (SRH), resulting in clinic closures and an estimated 7.5 millionadditional unintended pregnancies, 2.7 million unsafe abortions, and 22,000 maternaldeaths worldwide over the next year. It is further compounded by the sudden closure ofthe ACCESS programme, focusing on the sexual and reproductive health of marginalisedcommunities and working in complex and challenging environments, includinghumanitarian settings.SRH is fundamental to peoples’ health and wellbeing, with implications for nutrition,education, economic development, water, hygiene and sanitation, and health systemsfunctioning, amongst others. The UK government’s SRH-speci c cuts are thusexacerbated by budget reductions in related sectors, decimating programmes providingessential contraception, abortion, and reproductive health services worldwide. Thecumulative effects of funding cuts mean that commodities and service provision willcost more, further affecting available resources. Despite evidence and research on theprofound impact and bene ts of consistent and unconditional investments in SRH, it hassuffered from weak political commitment and stigmatising attitudes towards so-called‘sensitive’ issues related to sex, sexuality, and reproduction. Individualised to ‘personalresponsibility’, such approaches overlook social and structural conditions that mediateand shape peoples’ SRH and ignore established evidence.SRH has weathered devastating cuts before: the US government’s Global Gag Rule(GGR) has been a feature of US ODA policies since 1984, rescinded by DemocratPresidents and reinstated by Republican ones. Under President Trump, the GGR wasexpanded, further restricting funds for reproductive health and rights. At the time, anduntil these sudden cuts, the UK government insisted on its ‘world leading’ commitmentto and prioritisation of SRH. There are fears that these cuts will do more damage to SRHservice provision than the GGR, particularly as these cuts renege on existing contractsand commitments. President Trump did not renege on existing contracts andcommitments. The UK’s devastating cuts sow confusion and uncertainty, and riskirrevocably damaging carefully nurtured partnerships and relationships in and with theGlobal South.Instead of de-prioritising SRH under the guise of focusing on a pandemic response – or,ironically, priority areas of girls’ education and climate change – the UK governmentshould redouble its efforts to ensure SRH access because it shapes whether and howgirls can continue their education and how climate change affects lives as a socialdeterminant of health. SRH is also crucial to global health security and pandemicresponse, linked to existing frontline services and functioning health systems. Thegovernment, by framing these cuts as ‘tough but necessary decisions’ is being short-sighted and disingenuous, treating SRH as ‘collateral damage’. Made-marginalisedpopulations like women and girls, LGBTQI groups, and children will bear the brunt ofthese cuts.The lack of transparency surrounding these cuts marks a departure from historicallyhigh UK standards of transparency and accessibility of its bilateral funding for SRH.Prior to the merger, DfID was one of the highest ranked donors for aid transparency,whilst the FCO fell below the UK’s own transparency standards. Transparency concernsare compounded by obfuscation, blocking of Freedom of Information requests, andleaks surrounding the funding cuts. No meaningful consultation was conducted withexperts or key stakeholders and agencies within the development sector. These cutshave received a vociferous pushback from across sectors, with no support by any majoraid and development stakeholder.Clear aid commitments and aid transparency in published documents, as well asdetailed budgets that allow tracing of transaction trails are critical for accountability andthe measurement and monitoring of corruption within public spending. The suddenannouncement of cuts, avoidance of questions in parliament, reneging on existingcontracts and commitments, and decision-making without proper scrutiny shroudsdevelopment aid in secrecy and sets a disturbing precedent for the UK.The UN  nancing agenda calls for an ex-ante approach to ODA funding with clearcommitments. Cutting ODA will result in more urgent and short-term approaches,already seen with COVID-19 and other health emergencies. Evidence shows that in thelong term, investing in SRH is both a  nancial and a health and human rights investment.With further cuts into essential research and development, the government has createdan environment where critical decision-making is not being ‘guided by the science’.The ODA cuts create a dangerous vacuum into which philanthrocapitalists and privatefoundations will likely increasingly step. Philanthrocapitalism has a vertical approach toresearch, governance, and global politics that extends the power of individuals andfoundations, reproducing inequitable power relations and allowing them to set globaldevelopment agendas without any political mandate, approaching problems top-downrather than bottom-up. It also absolves governments – particularly in the Global North –of their responsibilities, and puts Global South countries in the position of grappling withthe personal priorities of individual donors rather than setting and carrying out their owndevelopment agendas and goals. Philanthrocapitalists’ ‘technical’ solutions, whileframed as apolitical, are anything but. While philanthrocapitalism may be ‘how the richcan save the world’, it sets up systems of return on investments’ alongside socialimpact; prioritising quick shifts rather than addressing the underlying causes of povertyand underdevelopment, or pushing for social transformation and justice. High-incomecountries fully implementing their ODA commitments in a clear and transparent manneris one of the most important checks to philanthrocapitalism in aid and development.The UK’s ODA cuts are not just a ‘new model colonial’ agenda, but a deliberatedevastation of DFID’s previous efforts to focus on long-term transformations that werelocally-led, owned, and negotiated. UK ODA is not a ‘giant cashpoint in the sky’, nor is it ahandout to the Global South. But these are the narrow, nationalistic and reductive framesused by a government claiming to be ‘Global Britain’ as it turns away from the world andits commitments._____________________About the AuthorsRishita Nandagiri is an ESRC Postdoctoral Fellow in the Department ofMethodology at the LSE.   Joe Strong is a PhD candidate in the Department of Social Policy at theLSE.   Tiziana Leone is Associate Professor in Health and InternationalDevelopment in the Department of International Development at theLSE.   Ernestina Coast is Professor of Health and International Developmentin the Department of International Development at the LSE.  Photo by Lucas George Wendt on Unsplash About the authorPosted In: Economy and Society | LSE CommentAll articles posted on this blog give the views of the author(s), and not the positionof LSE British Politics and Policy, nor of the London School of Economics andPolitical Science.LSE British Politics and Policy

Recent UK cuts to global health funding will cause irrevocable damage under the guise of ‘tough but necessary decisions’

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Recent UK cuts to global health funding will cause irrevocable damage under the guise of ‘tough but necessary decisions’

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