Money Matters: What the world spends on sexual health

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Sexual and reproductive health, family planning, and maternal health can be controversial topics. But they account for a lot of aid spending. Who’s giving the money away?

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Sexual healing

Sexual and reproductive health and rights are a big and growing area of development funding. In 2022, disbursements related to SRHR amounted to $14.2 billion, up from $12.7 billion the year before, according to a report from Deutsche Stiftung Weltbevölkerung, an organization that focuses on the health needs of young people.

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The United States is by far the dominant spender in this field, according to the report, both by total dollars and percentage of official development assistance spent. In total, the report says, the U.S. spent $9.4 billion in 2022, or 16.6% of all its funding.

Read: How donors spend on sexual and reproductive health and rights (Pro)

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Funding activity

We publish tenders, grants, and other funding announcements on our Funding Platform. Here are some of the ones which have been viewed the most in the past 10 days.

The Asian Development Bank will provide $170 million to improve access to quality and affordable health care services in India.

Enabel, the Belgian development agency, has allocated €3.2 million ($3.4 million) to improve learning outcomes and the socioemotional development of children in sub-Saharan Africa.

The U.S. Department of State has opened a $1 million grant competition to strengthen the rights of workers in the care economy in South Asia.

The European Union pledged €750 million ($802.04 million) to support vaccine production and improve health security in Africa.

The World Bank has approved $535 million to strengthen the social protection system as well as the livestock and aquaculture sectors in Pakistan.

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Downsizing localization

USAID has made localization its flagship policy for the last few years, so it was a surprise when the agency released figures last week showing that its total spending with local partners actually fell in the financial year that ended in September 2023, while the percentage of funding that it spent with local partners dropped even more, from 10.2% of eligible funding to just 9.6%.

What’s going on? In a special report exclusively for Devex Pro members, we broke down USAID’s progress on localization, and why it’s been slower than expected. But we’ve also got an exclusive opinion piece from USAID leader Samantha Power, outlining what she thinks is happening.

Read: USAID going backward on localization funding, agency report shows (Pro)

Opinion: How USAID is working to hit its localization targets

Special report: USAID and localization – A progress report (Pro)

Rightsizing aid

Meanwhile, my colleague Michael Igoe had a fascinating conversation with Max Primorac, a former USAID official under Donald Trump, about how the Republican party would rethink international development and aid spending. The focus remains on localization, but the social policy is very different.

Read: A US conservative's plan to beat the 'aid industrial complex' (Pro)

More reading: The Republican plan to ‘rightsize’ US foreign aid in a Trump presidency (Pro)

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Gavi giving

Gavi, the Vaccine Alliance is asking for $9 billion in new pledges, the organization announced last week in Paris. So far, Gavi has received just $2.4 billion of pledges, with $1.58 billion of that coming from the U.S.

The amount will cover the work the organization plans to do from 2026 to 2030, which includes expanding vaccine coverage and introducing new jabs, and fully immunizing children who don’t have access or have not received a single dose of routine vaccines.

Gavi CEO Dr. Sania Nishtar says she is “cautiously optimistic” that the organization will achieve its target.

Read: Gavi launches $9B replenishment target

Aid inequalities

One of the barriers to success for local organizations has always been the level of overhead funding they can access. And there can often be a difference between what INGOs are able to claim and what their sub-awardees receive.

In one case, according to a recent report from the Share Trust, backed by the U.K. government, an INGO received a 34% overhead rate, while the local partners got nothing at all. The report’s authors said this exposed an “unfair playing field” which went to the heart of the localization agenda.

Read: INGO claims 'unjustifiable' overhead, while local partners get nothing (Pro)

+ Check out our reporting and analysis on the localization drive within the development sector.

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