Investing in people
Health and education services allow people to participate in the economy and find employment and income generating opportunities. A healthy and educated workforce is more productive and enables an economy to be competitive, helping increase aggregate growth. Literate and numerate mothers experience lower infant mortality, have fewer children, and raise healthier and better educated children who, as adults, will be more equipped to become more involved in democratic processes. An informed citizenry is more able to hold accountable those in political and bureaucratic power.
Access to services is an important part of establishing the legitimacy of state institutions. Within Australia's immediate region there are areas — such as women's and children's health, gender equality, HIV/AIDS, malaria and education quality — in which progress is either slow or negative and the need for action is particularly compelling.
In 2007-08, Australia's approach to investing in people involves significantly increased investments in health and education.
Health
Context
The Asia-Pacific region faces many health challenges and is characterised by low investment in health and underperforming health care systems. Every year nearly 11 million children die globally, mostly from preventable causes. In the region, child mortality remains high in Burma, Cambodia, East Timor, Indonesia, Laos and Papua New Guinea, and has increased in Solomon Islands. Women in developing countries face high risks. Of the nearly half a million deaths globally each year resulting from pregnancy and childbirth, 99 per cent occur in developing countries. Emerging infectious diseases, including avian influenza, are causes of increasing concern in the Asia-Pacific region. HIV prevalence is growing in many countries in the region and the few countries that have managed to stabilise the epidemic face ongoing challenges to sustain their achievements.
Poor governance and underperforming economies have weakened health systems. Flawed systems, inadequate basic management and low per capita spending result in inadequate health services. Addressing the fundamental causes of failing health systems is critical to achieving and sustaining health gains, including against specific diseases. Improved health systems are also better placed to respond to the transboundary threats of infectious diseases.
Response
The Australian aid program will significantly increase its support to help improve the health and wellbeing of people in the Asia-Pacific region, particularly the most vulnerable. New funding of $530.8 million over four years through a Delivering Better Health initiative (outlined in Box 6) will strengthen the delivery of basic health services and address the key causes of premature death, contributing to global health goals of reducing by three quarters the maternal mortality ratio, and by two thirds the mortality rate among children under five, while beginning to reverse the incidence of malaria and other major diseases. This will be supported by further funding of $54.4 million in 2007-08 for Global Health Partnerships, also outlined in Box 6.
| Box 6: Delivering Better Health $585.2 million |
A Delivering Better Health initiative will invest an additional $585.2 million over four years, with $109.6 million in 2007-08 (including funding for Global Health Partnerships), to improve health in the Asia-Pacific region. This initiative will help achieve national health goals in target countries under three flagship components, in line with the Helping Health Systems Deliver policy1 for Australian health assistance, launched in August 2006: Strengthening health systems, through improving health policy, accelerating reform, and working towards sustainable financing. This will include improving information systems and human resource development, facilitating exchange of knowledge and skills among regional counterparts, and strengthening health supply chains. Addressing priority health needs of women and children, including reproductive health, nutrition, and preventative and care measures for childhood diseases. Assistance will: increase the focus on immunisation; sustain access to treatment for major life-threatening diseases of children; provide skilled care during pregnancy and birth; and introduce modern contraceptive methods. Australia will partner strategically with other donors with a proven track record of performance and innovation in improving women's and children's health in the region. Tackling diseases in the Pacific, helping partner governments better manage the burden of non‑communicable diseases such as diabetes through detection and prevention, and supporting malaria control measures, including treatment and preventative measures such as mosquito control and bed nets. Funding of $54.4 million in 2007-08 for global health partnerships will enable Australia to engage the expertise and scale of effective international partners to address priority health concerns, particularly maternal and child health. Partners will include the Global Fund to Fight AIDS, Tuberculosis and Malaria, and UNICEF. |
New assistance to the health sector in Cambodia will support the Cambodian government in strengthening its health system through better financing mechanisms and management, and reducing high maternal and child mortality rates. Significant new efforts in Bangladesh and Pakistan will have a similar focus, working closely with major development partners in those countries. In Indonesia, assistance for women's and children's health in the eastern provinces will be complemented by support to improve financial and human resource management, and through backing policy reform at the central level. In Vietnam, the aid program is collaborating with the World Bank to help Vietnam's government in its efforts to move towards a universal and sustainable model of health financing.
In the Pacific, Australia will help tackle the risk factors for chronic disease to address their high and increasing toll, and assist in forestalling the potential for huge demands on the region's health systems in the future. A new major effort will be made to tackle malaria, focusing on high risk populations in Solomon Islands, Vanuatu and Papua New Guinea. Support will focus on prevention and disease management, health systems development, and malaria research that could lead to new findings to inform future drug policy, treatment guidelines and vector control.
The new Delivering Better Health initiative will also put in place arrangements to support a significantly scaled up health program. These will focus on engaging a broader range of domestic and international partners, improving the evidence base, enhancing AusAID's ability to access and manage expertise and knowledge, and using performance payments to drive improvements in health service delivery.
Ongoing country and regional health programs will be consistent with the priorities of the Helping Health Systems Deliver policy. For example, in Papua New Guinea major investments will continue long-term strengthening of the health system, including critical areas such as human resources and drug supply. This will be complemented by measures to bring about more immediate improvements in basic health services, especially those addressing the major causes of death of women and children.
In East Timor and Solomon Islands, the Australian aid program will help improve the use of available resources for health by assisting these governments to implement broad sectoral programs that target agreed priorities, working closely with the World Bank and other partners. Support to the smaller island states of the Pacific can often be more effectively provided through regional organisations. Here also the aid program will work with other partners, to rationalise support for health systems.
The Australia-China Health and HIV/AIDS Facility will support the Chinese Government's efforts to respond effectively to HIV/AIDS and emerging infectious diseases, and to promote strengthened health systems, particularly health policy, planning and financing.
Diagram 4: Estimated ODA by DAC health sector sub-group 2007-08
Note: Diagram shows the proportion of estimated Australian ODA according to OECD Development Assistance Committee (DAC) defined sub–groups within the overall health sector classification. See note to Diagram 2 on page 63 for further details on sector classifications.
HIV/AIDS
Context
The HIV and AIDS epidemics present serious threats to development with profound humanitarian, security, social and economic impacts. Nearly 40 million people are living with HIV around the world and about eight million of these are in the Asia-Pacific region. Despite unprecedented funding from the global community, the situation continues to worsen in most countries and women and girls are increasingly affected.
Response
The Australian Government has already committed $600 million to 2010 to tackle HIV/AIDS in the Asia-Pacific region. The commitment is underpinned by Australia's International HIV/AIDS Strategy and supports large bilateral programs in Papua New Guinea and Indonesia, regional approaches in the Pacific and Southeast Asia, as well as global initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.
2007-08 will see new and expanded approaches in line with the White Paper including:
- an expanded HIV/AIDS research program that will improve the quality and availability of health development research to inform Australia's development assistance
- implementation of a capacity building program to strengthen the capacity of organisations and individuals in the Asia-Pacific region to address the HIV/AIDS epidemic
- increased funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria of up to $45 million in 2007-08
- support to Papua New Guinea and the Pacific islands to meet their commitment of as close as possible to universal access to HIV treatment in 2010, and
- enhanced engagement with the Asia-Pacific Business Coalition on HIV/AIDS in its work with national business coalitions in Papua New Guinea and elsewhere.
Education
Context
Education has a central role in reducing poverty, providing the foundations for economic growth, and yielding additional benefits including in health and gender equity. Countries that have achieved high rates of growth have built their success on strong, broad-based education systems. Reflecting this, universal primary education and gender parity across all levels of education are Millennium Development Goals.
While there has been some progress towards these goals, 77 million children remain out of school worldwide, of whom one-third live in the Asia-Pacific region. Most countries in the region are some way from providing all children with primary schooling, and secondary school enrolments are generally low. Gender equity remains an issue — of the region's 26 million children out of school, 16 million are girls. And getting girls and boys to attend school is only part of the challenge. The quality of education provided to the 334 million school children in the region is often poor, not providing students with the skills needed for productive employment.
Weaknesses in education are frequently driven by a shortage of resources, poor policy and weak management. Many developing countries' budget allocations for education often cover little more than teacher salaries, with school infrastructure and teaching materials left under-resourced. These already scarce resources are often further eroded by wastage and corruption. With low and often unpredictable public funding, many schools charge fees — a major obstacle to increasing enrolments and keeping children in school.
Response
By 2010, Australia aims to help increase by 10 million the number of children attending school, and to assist improving the quality of education for an additional 50 million children. A new Delivering Better Education initiative, outlined in Box 7, will direct an additional $540.3 million over the next four years to improving education in the region.
To strengthen the governance of education systems, Australia will work with key public and private organisations to improve policy and administration. For example, in PNG, Australia will continue support for better public financial management in the education sector, including improving management of the teacher payroll to enable more efficient use of overall resources for education.
At the community level, Australia will back measures that increase family involvement in the management of schools and raise demand for greater transparency and accountability in government service provision. In the Philippines, this will involve contributing to major national reform to increase community participation in school management, including in managing school assets.
To address the lack of resources that inhibits education service delivery, part of Australia's focus will be on increasing the availability and quality of teachers, classrooms and learning materials. For example, in Indonesia, new resources through the Delivering Better Education initiative will expand a major program that is already providing support through loans and grants for the community construction of around 2,000 junior secondary schools. The additional resources will help Indonesia introduce a new English language curriculum and improve the training and management of teachers.
Australia will assist partner countries reform their vocational and technical education systems to improve their relevance for today's job markets, both domestically and internationally. In 2007-08, Australia will work closely with other partners in East Timor to further increase the knowledge and skills of East Timor's youth. A skilled workforce is the cornerstone of economic development, and work-ready youth will be better placed to benefit from emerging income-generating opportunities.
Assistance will be provided to improve employment prospects for youth in the Pacific. Establishing the new Australia-Pacific Technical College will raise vocational and technical skills, supporting the growth of Pacific island economies by training larger and better-skilled workforces. The college will graduate 3,000 students over four years in automotive, construction and electrical, manufacturing and engineering, hospitality and tourism, and health and community services.
Increased assistance to Islamic education in Indonesia will continue to help improve the standard of education provided through moderate Islamic schools. Increased support will upgrade teacher training programs to meet national competency standards in selected provinces. Assistance will also improve English language training methods, facilitate gender mainstreaming, and support school-based management. Support for Islamic education will also be expanded in the Philippines, Bangladesh and Pakistan.
Responding to the growing demand for English language skills, Australia will support improvements in the quality of English language teaching in primary and secondary schools. This will be achieved through training teachers, and producing and distributing improved learning materials. Informal English language initiatives will also be supported. For example, in Bangladesh, Australia will partner with United Kingdom's development cooperation agency (DFID) to support English language television and radio broadcasts, complementing a package of teacher training and English language kits.
Scholarships
In addition to the Delivering Better Education initiative, the Government's Australian Scholarships initiative is providing $1.4 billion over five years from 2006 to enable future leaders from developing countries across the region to undertake postgraduate study in Australia. Scholarships foster enduring people-to-people links and have benefits across many sectors, well beyond the education sector.
Scholarships include Australian Leadership Awards (ALA), with 150 to be offered in 2008. ALA are also provided as fellowships for short-term study hosted by Australian organisations and combining specialised research with professional workplace attachments. Over 360 fellowships were awarded in 2007 and the number awarded will increase in 2008.
In addition to academic study opportunities, ALA scholars will also be able to participate in a Leadership Development Program. This will enhance their skills, knowledge and networks, helping to equip them for future leadership roles in their communities, businesses and governments.
These ALA scholarships and fellowships are in addition to the 1,000 Australian Development Scholarships (ADS) awarded annually for tertiary and higher education, and managed through AusAID's country programs.
Diagram 5: Estimated ODA by DAC education sector sub-group 2007-08
Note: Diagram shows the proportion of estimated Australian ODA according to OECD Development Assistance Committee (DAC) defined sub–groups within the overall education sector classification. See note to Diagram 2 on page 63 for further details on sector classifications.
1 See www.ausaid.gov.au/publications/pdf/health_policy.pdf