As other donors lag, BRICS bringing new resources to development: GHSI Report

Brazil, Russia, India, China and South Africa are injecting new resources, momentum and innovation into efforts to improve health in the world's poorest countries, according to a report released on the eve of the 2012 BRICS Summit. Coming as many traditional donors reduce or slow their spending, the report explores the expanding influence of the BRICS on global health and development.

While all five countries have been engaged in foreign assistance for decades, the report finds that the size and scope of their efforts have grown rapidly along with their economies. Although G7 donors still provide far more total assistance, the report estimates that the average annual growth in the BRICS' foreign assistance spending between 2005 and 2010 was more than ten times higher than that of the G7.

"As global economic developments reconfigure the quantum of international assistance, the world is looking to emerging economies like the BRICS for new resources and innovations to improve health in less-developed countries," said Sachin Pilot, Minister of State of Communication and Information Technology "The BRICS champion models of cooperation anchored in their own domestic experiences, uniquely positioning them to provide health interventions and technologies tailored to resource-poor settings."

The report, by Global Health Strategies Initiatives (GHSi), an international nonprofit working to improve health in developing countries, is based on a detailed analysis of the BRICS' global health and development efforts and the contributions of their innovative health programs. The report was released in New Delhi, India, where the BRICS Summit, including a heads of government meeting, will be held from 28-29 March.

The GHSi report finds that the BRICS approach foreign assistance differently than traditional donors, largely due to their own domestic experiences. In health and other areas, the BRICS emphasize South-South cooperation and technical support that aim to build capacity and self-sufficiency. The report also describes important contributions by the BRICS to multilateral health initiatives including Brazil's role in founding UNITAID and Russia's role as a founding donor to the GAVI Alliance's Advanced Market Commitment on pneumococcal vaccines.

"The BRICS are increasingly focusing on health and development as part of their global assistance efforts and pioneering new the models of cooperation and collaboration," said Anjali Nayyar, co-Executive Director of GHSi. "As the BRICS continue to innovate in R&D and delivery models, they will play an increasingly important role in improving health outcomes in some of the world's poorest countries."

While not all the BRICS have robust health assistance programs, all have made advances and implemented innovative programs as they work to address their own major health challenges. For example, Brazil's landmark 1996 commitment to provide universal access to effective HIV treatment significantly influenced global policies on access to medicines. China has been a leader on malaria treatment in Africa while South Africa is pioneering the introduction of new molecular diagnostics for tuberculosis (TB). These types of examples are providing unique models of success that are influencing health efforts in other developing countries.

"The BRICS countries are playing an increasingly important and often distinctive role in global health and development assistance, even as traditional donors rein in their own spending," said Yanzhong Huang, Senior Fellow for Global Health at the Council on Foreign Relations and editor of the Global Health Governance Journal. "For instance, China is expanding its foreign assistance and supporting programs based on its own development and foreign policy experiences and needs."

Beyond providing assistance, the report also documents how public and private sector innovators in the BRICS countries are producing high-quality, low-costs health technologies that have revolutionized health access among poor populations. Indian manufacturers, for example, have played a critical role in driving down prices for vaccines and HIV/AIDS medications.

While India is currently the largest producer of low-cost drugs and vaccines, each of the BRICS is investing heavily in science and technology, including health R&D. China has pledged to increase R&D expenditures from 1.3 percent of GDP in 2005 to 2.5 percent of GDP by 2020, and the government is working with vaccine manufacturers to scale up production for global markets. Russia has announced a US$4 billion investment in pharmaceutical development. The GHSi report highlights how increased health innovation in the BRICS could have even greater impact moving forward.

"The BRICS countries are already cooperating in areas such as health, agriculture, science and technology," said Rani Mullen, a Visiting Fellow at the Centre for Policy Research. "As these collaborations continue to expand and deepen, they could have significant health impact and potentially transform the way countries work together to improve health in the developing world."

At a meeting in 2011, the Ministers of Health of the BRICS countries declared their commitment to work collectively on health and to support health efforts in other developing countries. As assistance spending increases, BRICS countries are also formalizing their assistance strategies more broadly. Brazil, Russia, India and South Africa all have or are launching central assistance agencies and China recently issued a white paper outlining its approach to foreign assistance.

The GHSi report notes that the summit will help generate greater momentum for collaboration in health and development. India, for example, has been championing the creation of a BRICS Development Bank to formalize and coordinate assistance efforts. The report also cites a number of possible subject areas where the BRICS could coordinate their efforts, including TB innovation, prevention and control of non-communicable diseases, polio eradication, disease surveillance and access to vaccines.