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DEVE European Parliament
Follow its sittingsMaria Groenewald
Humanitarian action, I cannot stress that often enough, must remain strictly needs-based and guided by the principles of humanity, impartiality, neutrality, and independence. In an increasingly politicized environment, this is not given. We are seeing growing risks of humanitarian action being instrumentalized to serve migration, security, or broader foreign-policy objectives. The communication should therefore act as a clear political anchor to prevent such trends. This means ensuring that decisions remain needs-driven even in politically sensitive crises, ensuring humanitarian access in fragile and conflict-affected contexts, and strengthening protection for humanitarian workers and the communities they work with and for.
At its core, it is about safeguarding the independence of humanitarian action. Second, the EU must preserve and strengthen a diverse humanitarian ecosystem. The strength of EU humanitarian action lies in its partnerships, bringing together NGOs, local actors, the Red Cross movement, and UN agencies, each with distinct and complementary roles. European NGOs, in particular, contribute with their proximity to communities, entrusted partnerships, their operational flexibility, principled delivery, and ability to reach the most vulnerable in hard-to-access areas. This diversity is a strategic asset.
Therefore, it is essential to treat civil society not only as implementers, but as equal partners that reinforce the legitimacy and effectiveness of EU humanitarian action. This requires maintaining predictable, flexible, multiyear funding, and ensuring that localization is meaningfully embedded in both policy and practice. At the same time, we must remain vigilant to protect sectors that are at risk of neglect, such as protection, education and emergencies, mental health and psychosocial support, gender-based violence, sexual and reproductive health and rights, and disability inclusion. These are not secondary priorities. They are central to effective humanitarian response and must be reflected in funding decisions.
Third, fragile contexts must be placed at the center of EU external action. Action. Fragility is no longer the exception. It is increasingly the norm, sadly so, and a key driver of humanitarian needs and instability. With the upcoming staff working document on the integrated approach to fragility, the EU has a clear opportunity to promote a more coherent, long-term approach in fragile contexts and to apply the humanitarian-development-peace nexus while fully respecting humanitarian principles as a standard way of working for all contexts presenting different degrees of fragility.
Together with Concorde and Eplo, we call for fragility to be recognized as a cross-cutting priority within the Global Europe instrument in the next MFF. This requires aligning policy and funding to support long-term people-centered engagement grounded in operational realities, and ensuring that flexibility is used to support predictable needs-based responses, not to introduce additional uncertainty. This brings me to the next multi-annual financial framework. If the EU is planning to remain serious about responding to rising needs, then predictability and adequacy of funding will be essential. As commissioner Hajj Al Abib underlined in front of this committee in March, the EU is facing growing pressure to respond to multiple crises with constrained resources.
This makes the choices in the next multi-annual financial framework all the more critical. In this regard, the proposed €25,000,000,000 for humanitarian action is a very welcome political signal. It should be understood as a baseline, not a ceiling, for the next MFF anchored in the regulation. It reflects the reality of recent years when initial allocations have been systematically proven insufficient, requiring repeated top-ups. Anchoring this level is critical to ensure that humanitarian action is not forced to compete with other priorities.
Equally important is the balance between programmable and non-programmable funding. An 80/20 split reflects operational realities. The need to combine long-term engagement with the capacity to respond rapidly to crisis. This balance helps ensure that humanitarian action and crisis response are adequately resourced, while avoiding the recurrent underfunding we have seen in the current framework. Coming to my last point, let me briefly address ongoing discussions around the so-called humanitarian reset and funding architecture.
We all recognize the need for reform in the current context of rising needs and shrinking resources. At the same time, there is a strong expectation that major donors such as the EU will help ensure that the reform remains principled, inclusive, transparent, and grounded in operational realities. What does this mean, concretely? First, promote a more inclusive and accountable humanitarian reset reform to ensure the process is informed by the operational experience of the full range of humanitarian actors, including NGOs and local partners, and that the reform process remains transparent and accountable to the broader humanitarian community. Second, keep sectors at risk of neglect high on the agenda during prioritization discussions, and champion reform processes that build on the diversity and complementarity of actors within the humanitarian ecosystem.
To conclude, the EU has both the tools and the responsibility to lead, and leadership demands coherence between policy, funding, and practice. The upcoming communication in the next MFF is a key opportunity to ensure that the priorities you endorse at EU level reflect both the values of the EU citizens and the realities faced by millions of people living in humanitarian crisis around the globe. Your role is essential in bridging this gap by championing principled needs-based humanitarian action and ensuring that commitments are backed by adequate, predictable funding. These upcoming decisions are defining moments to reaffirm the EU's leadership, strengthen partnerships in a diverse humanitarian system, and safeguard an effective and efficient humanitarian response. As voice, we stand ready to work with you to help turn these ambitions into reality.
Thank you very much.
Barry Andrews
Thank you, Maria, and for that introduction. So we will get into some exchange now with our members, and we'll start with the DEVA standing rapporteur for humanitarian aid, which is Miss Lera Bahrain, and then we'll go to the coordinators of the political group. So, Lera, you have two minutes. Thank you.
Leire Pajín
Yes. Thank you so much, chair, and thank you to the secretary Adelso for organizing this vital exchange of you. Welcome, and thank you to the representatives of Voice for the clear messages. Let me now switch to Spanish. Let me.
Start by thanking the VOICE representative for their analysis. We agree with it. It is fully in line with the report that this house approved only a few months ago, in a context where the vacuum of humanitarian aid has increased as in the last six months. And we have actors who have taken a step back in their commitment to humanitarian aid. And so the European Union, more than ever before, must step up and take this role of leadership within this context.
We also agree with the need for a basic commitment to funding. Here in this house, we've defended that. It's good news. We've gotten some good news, but we need a base. We agree with the necessary reform of the system to make it more efficient, more effective, and above all, really much focused on saving lives and to guarantee the implementation of the international humanitarian system and, of course, to guarantee its principles as well.
And we must also strengthen local actors so that they can play this fundamental role with guarantees of impartiality, neutrality, and, above all, in safety. I wanted to ask you about humanitarian diplomacy. Some member states such as Spain have presented their strategy for the coming years on diplomacy in the humanitarian area, and the Commission will be presenting its own. And I think we need to put this at the heart of our political agenda for foreign affairs today. And this is why I wanted to ask you, in your opinion, what would be the main elements for a strategy of humanitarian diplomacy for the European Union?
Thank you.
Barry Andrews
Gracias, Lera. And now we go to the EPP Group. On behalf of the EPP Group, Niels Goeking will have the floor for two minutes. Thank you, Niels. Yeah.
Do you mind?
Niels Geuking
Yes. Humanitarian aid is one of the cornerstones of EU external policy. There's no doubt about that. And that means we need to bolster the resources available and get up to 25,000,000,000. The problem is we have so many other issues and areas where we need to get involved, especially at a time when the US is withdrawing from certain areas as well.
So we're trying to bolster financial resources, and then use those resources in the best way possible. But, of course, at the end of the day, we're getting more and more tasks foisted upon us. And the member states are kind of abdicating responsibility for some of these things. We're still a long way from 0.7% of the GNI. We need to make sure that we keep pressure on the member states to keep that commitment, rather than foisting all these tasks on us.
Now apart from that, I've noticed that you mentioned the 25 billion that you think should be increased for the MFF. Access to reserves is something that we can push, of course. The question is just, predictability is important. There's no doubt about that. But how can we make sure we are flexible?
How do we build in flexibility? We've talked about this with the commissioner, and we were at issue with how this should pan out. I can be frank about that. If we're talking about the minimum base is 25,000,000,000, the issue is if we need more money, where are we gonna get it from? We're saying quite clearly that this can't be to the detriment of the other pillars of funding.
That means if we need more money, the member states have to shoulder that responsibility rather than take it from other areas of European responsibility. And the question here is how do you understand the greatest level of flexibility being brought in added to predictability if it is not to the detriment of other areas of funding? Do you have an approach?
Barry Andrews
Okay. That's very clear. And now we go to S and D. And on behalf of S and D, we have Muriel Laurent. You have the floor for two minutes, Muriel.
Thank.
Murielle Laurent
you. Thank you, Chair, and thank you very much, Madame Grundwald, for being with us and for the regular exchanges of views that we have with you. That's very valuable and precious for us. Now one of the most recent publications, The Voice, makes it very clear that the diversity of humanitarian actors, and in particular the role of local and national NGOs, is essential to guarantee effective responses that are really based on the realities of the local communities. Now in practice, these NGOs are often confronted with obstacles, some of which you have mentioned, when it comes to ensuring direct access to funding and to setting up partnerships, even though they are among the best-placed actors to intervene.
Now my question is how can the European Union really set up a genuine model of complementarity in which all of those involved, and in particular local NGOs, really do have effective access to funding and to good coordination and decision making, and what would you recommend in that regard.
Barry Andrews
Thank you. Okay. Thank you very much, Muriel. And now we have, there's nobody here for the Patriots or for ECR. So maybe we will come to renew.
Charlotte, do you want to wait till the second round, or would you like to make a comment now?
Charles Goerens
I'm in your hands. I'm entirely in your hands. Thank you very much. In that case, I do give you the floor. Charles, you have the floor for two minutes.
Thank you. Thank you very much. And thank you for the presentation with a clear definition of the priorities when it comes to humanitarian aid. I would agree essentially with your presentation, most of which I have heard. I imagine that what you said before I arrived would also be acceptable to me.
Now insofar as this minimum of €25,000,000,000 is set out in the instrument, I am less skeptical than my colleague who previously was. I think that in practice, we will not run into too many problems. We do need the flexibility, of course.
And.
Charles Goerens
Now, after having discussed these issues with the commission, I think that there will be fewer problems in practice than has been suggested, and the member states will step up. But I have a simple question. There is a necessary balance to be struck between what is programmable and what is not programmable. Can you be more specific on that? Because it was a bit vague.
Thank you.
Barry Andrews
And there is just, would you like to come in for the greens, Mr. Karem? You have the floor for two minutes.
Damien Carême
Thank you. Thank you, Chair, and thank you, Madame Grenwald, from VOYCE for having given us a clear sense of the present situation in which humanitarian aid finds itself at the present time. And as colleagues who have spoken previously, I would agree with your analysis of what is required to have a genuinely effective international humanitarian aid. Now humanitarian aid is a necessity, an absolute necessity, and it should not be put into competition with other sectoral needs that we have. We need a strong commitment and the €25,000,000,000 that has been provided for in the MFE is essential, but that may not be sufficient, as you have suggested, especially with the withdrawal from the humanitarian aid sector of The United States.
I think that we need to find ways to increase this aid. I think that is important for us to be proud as Europeans. So I think that we need to be as effective as possible, as you have called for.
Barry Andrews
Maria, we have a wide range of questions on humanitarian diplomacy, on flexibility and the localization programmatic against non-programmatic and various other issues. So let me give the floor back to you for about 10 minutes. Well, as long as you need. Thank you, Maria.
Maria Groenewald
Thank you. Thanks a lot for all these interesting and important questions. And thanks, MEP Parin, for always championing principled humanitarian action. Very much appreciated. And also very important to point out to humanitarian diplomacy, which is so much needed in these days where we see these rising needs, and humanitarians are there to alleviate the suffering, but the crisis also needs to stop.
So we need humanitarian diplomacy more than ever. And we have, in our position paper on the upcoming communication as voice, identified a few key recommendations, what the main elements of EU humanitarian diplomacy should be. So first, we would like to see a commitment that is consistent and coherent and encompasses all the different actors within the EU, DG ECHO, DG INPA, the EAS, EU delegations, relevant commissioners, and member states. We need a joint approach. You were mentioning the new strategy in Spain, which is also showing a lot of important aspects we support as voice.
And then there is the upcoming communication and humanitarian action that is also very much needed as part of the EU strategy. But these documents, these different strategies between the EU member states and the commission should also be aligned, for example, on the topic of humanitarian diplomacy. And it's also important to note that humanitarian diplomacy should be prevented from being instrumentalized by any political or other considerations. It's really about advancing the work on humanitarian diplomacy with respect to the humanitarian principles and should also entail a pledge that humanitarian access and the protection of civilians as well as the respect of IHL, as I mentioned before, really need to be high on the political agenda and the political dialogue at global, regional, and local levels. And so I also welcome that this committee will discuss this afternoon the protection of humanitarian workers.
So these are a few key elements, and then I also invite you, of course, to look into our position paper for more details on the topic of humanitarian diplomacy. Really, it's so important that the EU steps up this work. On the question of money, I very much agree with you that EU member states should also step up their engagement on ODA again. As I said, the EUR 25,000,000,000 is a very much welcome political signal. We also know it's a draft, so we need all your support that this figure will also be the last one in the final version, obviously, as a baseline, as I said, and not as an end budget because we don't know how the humanitarian crisis will develop.
But we do know already that we see more protected crisis than ever. So these needs are foreseeable in a way. And then it's still also important why we discuss alternative sources of funding and look beyond traditional donors. We still also need to remind the EU member states that they each have a responsibility to step up the humanitarian funding. We know that it's not about the money.
It's about a political decision. It's about political will, whether humanitarian action receives the funding needed. So it's important to remind the 0.7% target and the fair share for humanitarian action. In terms of the diversity and local partners, thank you, Madam Laurent. Thank.
Thank you very much for the question.
Maria Groenewald
Because we talked about the needed reform in the humanitarian system, and this reform needs to be shaped together with the INGOs and local and national NGOs. As voice in our current strategic plan, we have included for the first time in thirty plus years of voice localization and locally led humanitarian action as a key part of our work. And with the support of DG ECHO, we are also going to increase this work as we know this is the way forward. And this is also the way how our members are working for many decades in close cooperation with the local communities, the local NGOs. And we have also developed a few key asks for the communication to include in the communication also commitments regarding localization.
So in the EU context, where it's not possible to fund directly local and national organizations, it is still essential to support the role of the intermediaries. The INGOs working with the local partners and not only since yesterday, as I said, for decades in so many cases, to really create the conditions that make these partnerships equal partnerships and efficient and effective. And we shouldn't fall into the trap that localization is cheap. We also need funding to advance on the localization agenda. What is efficient and effective is the work of the NGOs with their local partners, and we have a lot of publications who showcase the evidence of this effective and efficient partnership.
On the next question, just a second. Thank.
you. And thank you for.
Maria Groenewald
le 20 balance. Indeed, this is not an easy question. And together with our partners, we have also taken some time to develop this ask of 80% for programmable and 20% for non-programmable. Why we are asking for this share of funding now is to ensure predictable, adequate funding for humanitarian action and crisis response. And we would like to see, as I stated earlier, we would like to prevent that structural underfunding will happen in the next MFF, as we have seen in this MFF.
And we welcome, of course, the yearly top-ups we have seen in this MFF, but there can be a better mechanism to have predictability and flexibility in the next MFF. And this balances also the ambition of being flexible while also already planning ahead for the protected crisis we have seen. So with 80% for long-term funding and programs and 80% for rapid non-programmable needs, have calculated that this could be a realistic and planable way forward. And then the last question from the Greens. I appreciate the support, and I think it's really important that MEPs are also going back to their national governments or counterparts in the national governments and support this course.
The numbers are shockingly high. We're in 2026 and still don't manage to break the cycle of suffering, which is also, and we do see that there is a way to break the cycle of suffering. We haven't talked about the humanitarian-development-peace nexus yet a lot. This is a way forward, and we have also plenty of evidence in our publication that shows successful implementation of the so called nexus approach. It's the only way forward, combining humanitarian action alleviating suffering with long term programming and planning sustainable projects under the development cooperation angle, and peace work combined with humanitarian diplomacy.
Otherwise, there is no ending to this cycle of suffering for millions of people. Thank you.
Barry Andrews
Thank you, Maria. We have the opportunity for a second round of questions. Mister Buhlmann has indicated a few questions of his own. So, Udo, please. You have the floor.
Udo Bullmann
Thank you, Maria, for being with us and for this interesting discussion. Two points on the root causes and how to tackle them. Please help us to understand what is from the point of view of your organization and member organization, what is the situation currently in the refugee camps, especially in Sub Saharan Africa, but not only, because this situation directly corresponds with an issue that was raised by our fellow colleague Niels Goeking, the upper ceiling question. Niels and colleagues, if we, with our families, were in a refugee camp in Africa or elsewhere, and on a day-to-day basis not able to feed our children, my question is what would we do? My guess is we would leave because we will not witness our children starving.
And most probably, if.
there.
Udo Bullmann
There is no other chance, we go north. And nobody is going to stop us. Either you kill us in the Mediterranean or somewhere else, or we go north. And the very question is not whether we would like to see an upper ceiling, yes or no. The very question is where to invest our money.
Of course, you can militarize your fences, but it will not solve the problem. So the concrete question is, where are we here? And the second question, which directly relates to these growing needs that are produced, there is a production of need as we all know because needs are not just there. Either it's climate change and the impact of environmental disasters, or it is wars. That is the two main reasons for needs.
What is going on in these growing quarrels, military conflicts, especially in Africa, when at the same time, people invest in the military conflict? And that is my second question to Maria. You are in talks with the governments. You are in talks with the commission. We have a catchword that is policy coherence here in the European institutions.
When you talk and it's not about only echo and in part. No. It's also about trade and many other aspects. We are in the very process of negotiating trade deals with countries that fire up military conflicts that lead us to growing numbers in refugee camps. So is this part of our conversation with the Emirates, with the Saudis, and with others or not?
What do they say when you talk to them about the growing need in Africa and in refugee camps? Do they answer? Do the commissioners answer these questions? Do the ministers and government people on national scale answer these questions? I would be keen to get to know them.
Barry Andrews
Right. Thank you, Udo. So, I mean, I just wanna echo what Udo has just said. I think there's, you know, you take trades, and you've raised questions of humanitarian diplomacy. You take other elements of Europe's external policy, and you try to make sense of it all. How do they all relate to each other?
And are we therefore maximizing the potential of our external policy in general or not? And is it leading to the spillover of problems for Europe? And I don't think there's a really coherent, literally, strategy around this at all that connects up our humanitarian efforts, our development efforts, our diplomatic efforts, our trade efforts, even our democracy support. So I think there might be a question for us there that we could address at another time. So, nevertheless, we have these increasing needs, Maria.
And how do we deal with this? Well, our funding is going down. Our costs are literally going up all the time because of the supply chain, which is really challenging right now. You know, all of the NGOs are struggling with inflation in their own supply chains. So, how do we deal with costs?
We can let people go. That's the obvious thing to do. So let staff go. Or we can do what can we do around our supply chains? What can we do around joint procurement?
What can we do around localization? You say localization is not cheap, but it's cheaper. Let's be clear about it. And I'd just like you to go into a little bit more detail about what your thoughts are around the humanitarian reset. Very specifically, what concrete changes, you know, even under the headings I've just pointed out.
Second point is just about fragility. As you say, it's the new norm. And, you know, how would you have a proposal around how we would make this a cross-cutting priority in the MF in the Global Europe instrument? Because it's going to be referred to in the humanitarian communication, where we'll have the Global Europe instrument, but how do we take it out of strategy and put it into legislation, essentially, is what I'm trying to figure out. And then the final thing is around the communication itself.
We will hope that member states, when they sit around with this communication, that they will do something about it, that there will be conclusions that arise from the council at some point. So are you in discussion with member states about what will be the afterlife of the communication, which we expect out on May 27? So what's next? In other words, it's all very well to have the communication, but what does it do after that? So there's some additional questions, Maria, and pass the floor back to.
Maria Groenewald
Thank you, Vildan Gudo. Thanks a lot. So in terms of migration, first of all, the evidence shows, the numbers show that while I'm not an expert on migration, the numbers show that most people fleeing conflict are either becoming internally displaced people within their own borders or make it to the neighboring country. The vast majority never makes it to Europe or from different places to the US, etcetera. It's really a struggle within neighboring countries of a conflict and within an affected country.
But then it's also not the role of humanitarians to work on migration topics. As humanitarians, we support people in need, whether they stay or leave. It's rather a question again of the humanitarian-development-peace nexus, how to best connect the responses and the way forward so that we break this cycle of suffering and provide a future, and create a path for a future of millions of people. And on the other hand, it's also important to note, in light of the upcoming staff working document on the integrated EU approach to fragility, that we need to remain engaged in all fragile contexts no matter which degree of fragility or how politically sensitive the context might be. And staying engaged means, as humanitarians, together with the development partners.
It's not something that humanitarians can solve alone, the high number of people in a fragile context. And in terms of the question of trade deals, here, the leading role I was talking about earlier of the EU as principal humanitarian donor, but also as a standard setter, is more critical than ever. To lead by example that humanitarian principles are not nice to have, but the foundation of the work of the EU, and also show this to potential new partners how principled, effective, and efficient humanitarian action can be delivered. And then being coherent, of course, in the approach to other policy areas. And then, Barry, on the funding cuts and the high inflation, indeed, supply chain is one of the areas where also evidence shows that a lot of funding is needed to organize the supply chains.
And we very much welcome DG ECHO's approach to a more integrated approach to the supply chain with the new leadership group on supply chain. We have contributed, and many of our members are working actively in this group to make a real difference of a more aligned supply chain system that is more cost-efficient. And localization does play a role in it. And when I said it's not cheap and why I was being a bit provocative, obviously, but it's, of course, important to remind that quality humanitarian action comes at a price for international and local partners who have proven to be the most efficient and effective, as many studies also show. So, it's also important to remember that quality humanitarian action also comes with a price, while, of course, working in a localized way in terms of supply chain, buying from local markets, etcetera, is also an important part of this approach to me as cost efficient as possible.
The concrete changes in terms of the reset, I outlined a few already. What is needed in the humanitarian system is a reform. It's not only a reset from one UN agency, but it's a participatory approach from all actors involved, as the context we are working in is very diverse. Diverse actors and diverse funding instruments are needed. So coming together and renewing a system only can happen collectively, and not by focusing on just a few actors or a few funding instruments. So concretely, we would like to see a more inclusive and participatory discussion around the reform of the humanitarian system, recognizing the important complementary role of the different actors.
And then you were asking about cross-cutting, and you were mentioning fragility. Right? Of course, super important, as I already explained, as humanitarians, we cannot respond to the fragile context alone. Development actors are needed, and there is a lot of interest in staying engaged to not let fragile contexts fall out of the radar. We already see too many neglected crises.
Some call them forgotten. We call them neglected. Because, again, it's a political choice not to respond. So we have to come together and the integrated approach to fragility the EU is developing between different services, DG ECHO, DG INPA, EAS, is the right way forward to address these growing needs. I pointed out in my speech earlier that humanitarian needs are also being increased due to the increased number of fragile contexts.
So it's absolutely indispensable that this is going to translate into concrete actions, which, at the end of the day, also means mobilizing funding for those contexts. And then in terms of the conclusions we would like to see from member states and the way forward to the communication, of course, first, we are very keen to read the new communication, very much looking forward to it, expecting that principles, IHL, and the role of the diverse actors in the humanitarian ecosystem. As I mentioned before, Red Cross movement, MSF, UN, and international and national NGOs will be well recognized. And then we will follow closely as voice also the hopefully council conclusion that will come up, and a clear road map how to implement. We have also seen attempts to write a clear road map and the yearly reporting after the last EC's communication on Humanity in Action from 2021.
And there was, when I recall correctly, a first progress report one year later. It would certainly be good to see also progress reports on a yearly basis after the new communication will be published, so that the parliament, the NGOs and everyone interested can also see how advancements are made and how we can also work together where there might then be areas of improvement. Okay.
Barry Andrews
Well done, Maria. Coping with all of those questions comprehensively. So I will conclude this by just hearing from DG ECHO, Mister Arnaud DuPont, who is head of unit for strategy, international and inter institutional relations. And given that you're responsible for inter-institutional relations, we are interested to hear what the levels of cooperation are ahead of the communication with DG Interpath, something that we're very anxious to see. So at that inter-institutional, well, it's not inter-institutional, of course.
It's between the two DGs. Perhaps you could refer to that in your comments. So Antoine Arnaud, Antoine is the rugby player. Arnaud, you're very welcome, and you have the floor for 5 minutes.
Speaker 13
Thank you very much to all the participants in the meeting this morning, and I'm very optimistic after the set of questions that you raised. I think there was a great deal of alignment in terms of the challenges that we see, and there are many. But of course, we can bring some positive developments, hope, with the communication that we are preparing and that hopefully will address or contribute to address a number of these challenges. And also, I will not go very much into details of the MFL discussions, which are ongoing and for which there are dedicated negotiations. But what I would like to point out is that you will see consistency and coherence between what is the legal proposal that you have, that you have already seen, and that is being discussed, and the policy direction that this communication on humanitarian action will be showcasing.
Speaker 14
Because, really, I think the consistency, the coherence came back time and again in your intervention this morning, and it's certainly what we need considering the scale of the challenges that we have. And also maybe complementarity of action, which needs to be done, being mindful of the respective roles, responsibilities and the mandates, which are not the same, whether EU institutional mandates, as you are referring, but also policy roles between development, humanitarian aid or peace actors. But I think without coherence, not a great deal of progress can be made. Just I'll try to address a few of the aspects. I mean, yes, certainly, IHL and humanitarian diplomacy will be key element for us in this upcoming communication because we see that this is at both this is IHL is a bedrock on which we work, but it's also the attack and the constant undermining of IHL needs to be addressed.
Speaker 13
And we can possibly better address it through coherent humanitarian diplomacy being better rolled out, being enhanced in the way we work. And that will involve, as it was already mentioned, working with external action service, with member states, with the UN system, with NGOs. I mean, everybody should be on board to make sure that IHL is better respected. And this connecting this, it's of course, it's important because it's our common set of rules and values, but it's also important to get the results right and to lower the cost as well, because the nonrespect of IHL is having a very important bearing on the organizations we strive to deliver the assistance. On Fragility, which was another of your concerns, yes, we are this integrated approach to fragility will be part of this package as was already announced by commissioner Labib.
And on this, we will and have been working very thoroughly with DG Inpai in particular, but also with the other services. And as we are progressing toward the finalization of this paper, I hope when it will be public, you will see the outcome of this cooperation and this attempt to make the practical progress, while also setting the clear level of ambition in terms of engagement in fragile context. A few other remarks. Maybe I mean, the world of supply chain was mentioned. This is also, as you know, one of the areas on which we work, also because we cannot underuse the value of the euros that are being given to us by the citizens and by the taxpayers through the intervention of the budgetary authority.
So this is certainly one element where we want to increase the effectiveness of the system, and there will be others. It's one of the ways to bring further value, but also beyond the value, further efficiency in terms of being available to deliver assistance very quickly wherever we need. And as you've mentioned, the crises are many. On the need to partner, so of course, we very much value the work that we have in common with international NGOs, and these are, I mean, crucial partners. By far, the majority of the 200 plus certified partners with whom we work on a daily basis.
But we also want to keep having this rich partnership with the UN and the Red Cross movement. We will also see how we can work better with the private sector and philanthropies. This is also complementary elements for us to reinforce the efficiency of our interventions. And also beyond our EU member states, with whom we are also working very closely, we will also see what we can do with like-minded donors, because as we have seen in recent years, and notably with some decisions by major funders of the international humanitarian system, have a bearing on our overall efficiency. So we need to keep engaging broadly outside of member states and European donors.
These are a few of the elements that I wanted to mention. Maybe just to complement on a word on the reset, very quick, very shortly, just a few points. We will strive for a reset that is still needs-based on principle. We will also ensure that the reset at least push for a reset that is inclusive of the whole range of partners that have been mentioned today. And we will also continue to support the reinforcement of the role of humanitarian coordinators, also for this very need for coherence and consistency that I've just mentioned.
And thank you very much, and sorry for having been a bit long. I hope it was informative for you. Thank you.
Barry Andrews
Arnaud, thank you very much. That's very helpful. And yes, we hope we are all looking forward to optimism to the communication and to the working documents that will come from it, and hopefully an afterlife and conclusions at council level in due course. So we take a very short break, and then we'll start again at 11:00. Thank you, everybody.
Okay. Let's get going again on item number 5 on our agenda today. And, we're gonna have an exchange of views on the impact of two decades of humanitarian development assistance and the projected mortality consequences of current defunding to 2030. So, you know, look, we all know what the circumstances are. We're facing massive cuts, and there's a sort of a growing narrative I'm hearing around the place that, oh, well, it doesn't matter really.
It's all overstated. It was grossly inefficient anyway, and the cuts will force people to do things in a smarter way, and we needn't worry about it. However, as we'll hear, I feel, maybe, there will be, there is growing evidence that that's not the case at all and that these cuts come with costs, costs in human life. And as the development committee, that's something we really need to shine a light on and be intolerant of. And one of the leading authorities in this area from my own reading has been the Lancet, which is a globally renowned medical publication that has produced peer-reviewed studies which demonstrate the potential human cost in lives of the massive cuts that are happening, not just USAID, not just member states, but the reallocation of existing funding to European economic interests, to American economic interests, and away from the most vulnerable, away from the least developed countries, and away from the idea of no one gets left behind.
So we're not just looking at the volume, but also the reallocation. And these are the issues that are leading to some of the questions that we want to hear about today. About the, you know, and we're at a crucial moment here in this committee as we deal with Global Europe, as we deal with the MFF, the humanitarian communication, and fragility. So we're very pleased to welcome remotely and online one of the authors of this study, who is professor Davide Racella, who was a research professor and epidemiologist at the Barcelona Institute for Global Health, who has extensive experience in academic research and as a humanitarian worker in Sub Saharan Africa and Latin America. He's currently head of impact health at ISGlobal.
In addition, we are very pleased to have with us also joining remotely doctor Yukiko Nakatani, who is assistant director general for health systems at the World Health Organization, who will provide some insights on the global health governance perspective. DG Indpa and DG Echo will also intervene, as we go along. So, we will therefore get started with passing the floor to Professor Risela. So, professor, if you can hear us and see us. Yes.
Like, we can see you. If you can hear us and see us, you have the floor for 8 to 10 minutes. You're very welcome.
Davide Rasella
Thank you very much, and thank you for the opportunity to be here. I want very briefly to illustrate the study we have done on the impact of ODA in general. It's a project that we have developed with several institutes, Barcelona Institute of Global Health, the Brazilian Institute for Collective Health, and the Center for Health Research in Mozambique, Manisa, and is funded by the Rockefeller Foundation. Next, please. Okay.
So very briefly, I'll present the main results of our publication of a few months ago on the impact of USAID on health using 133 countries over 30 years, representing 6,600,000,000 people, integrating retrospective impact evaluations with forecasting and using
Barry Andrews
David, I'm gonna ask you to slow down a small bit so that the interpreters, before they say anything, you could slow down a small bit, and we we've got some time. So thank you, David.
Davide Rasella
Okay. Thank you very much. So a study that is global, including 30 years and 133 countries, with robust statistical modeling. Next, please. So we have evaluated when the last two decades, USAID was able to reduce a 15% high level of USAID funding, we're able to reduce high level 15% overall mortality and 32% child mortality globally.
We have the strongest effect on the reduction of mortality from HIV AIDS, nutritional deficiencies, diarrheal diseases, malaria, neglected tropical diseases. Next, please. When we projected the future, we were able to estimate that a complete defunding of USAID will cause up to 2,030,014 million overall deaths, including 4.5 million child deaths. This, and the important thing, is that other studies conducted by different groups with different methodologies and data sets were confirming the magnitude of this effect. This was our first study on this subject.
Next, please. This adds a huge dissemination, more than 1,200 articles and media outlets were right, including CNN, Washington Post, BBC, Financial Times. Next, please. So now we started more recently to evaluate the impact of ODA more broadly, including all the donors. We know that the preliminary data on 2025 related to ODA released by OECD came up one week ago, showing that there was a decrease in February '22, 3.1% of funding, the largest annual contraction on record, and the second consecutive year of decline.
Germany, that is now the largest contributor on ODA, followed by United States, United Kingdom, Japan, and France accounted for 95% of the total decline on ODA. And the United States alone drove three quarters of its decline. Bilateral ODA fell by 26%, and multilateral ODA declined by 12%. Next, please. As you can see here, the graph for each donor, major donor, there was, of course, the continuation and this decrease that started already years ago.
Overall, if we see in the aggregated DAC countries, there is a dramatic reduction in the last years. And, of course, just a minority of the countries are able to reach the 0.7 of GNI promised decades ago. Next, please. So we published in February a new study, more recent on the impact of two decades of all ODA from all donors, and projection for the future. So we use this methodology very similar to a previous one, including 93 countries over 30 years, 6,300,000,000 people, the integration of retrospective impact evaluation with forecasting and robust statistical modeling.
Next one. So we found that high levels of ODA funding were reducing 23 percent overall mortality and 39 percent under five mortality. And the strongest effects were in HIV AIDS, nutritional deficiencies, malaria, diarrheal diseases, and neglected tropical diseases, similar to what we saw with use eight. Next, please. We projected the future, and we did two scenarios.
In a care in case of a severe defunding scenario with huge reduction and the maintenance to very low levels, baseline levels of ODA starting from 2026, we will have 22.6 million all age excess deaths up to 2030, including c 5.4 million under five deaths. In case of a mild funding scenario that is more or less what is happening now, so a reduction of approximately 11% per year, we have said that 2025 was an exception, hopefully. But if we take the average over the last year, it's more or less 10 to 11%. We will have 9.4 million all age excess deaths, including 2.5 million under five deaths up to 2030. Next, please.
Also, this study has a huge dissemination in the major international outlets. Next, please. So we decided to evaluate donors, and we evaluated here the results of a reduction in funding by France, Germany, and United Kingdom. Without entering detail on the methodology that is somehow similar to our previous studies, we estimated that the past and ongoing reduction in funding by these specific donors are projected to result in 4,500,000 deaths related to the reduction of UK, 3.1 million deaths related to the reduction of France, and 2.8 million deaths related to the reduction from Germany. Next, please.
We also tried to propose a solution based on the implementation of well redistribution policies proposed in recent high-level international agreements to support developments such as the Rio de Janeiro, G20 leaders declaration of a severe commitment, and the OECD G20 inclusive framework on BEPS. And so we modeled the potential support of welfare distribution policies to a d o d a funding. And we discovered that they can fully offset the health impacts of the current ODA defunding crisis. And in the current context of ODA defunding, that can be associated with from 6.6 to 29.5 million averted deaths by 2013, depending on the policy type, targeting population, and taxation level. Next, please.
Here, a table showing how a crypto tax, for example, including 3% of the top 10,000 holders can raise 32,000,000,000 US dollars and can save up to six point five million deaths up to 2,030, while taxation of 3% of the ultra high net worth individuals, billionaires, can raise 343,000,000,000 US dollars and save up to 29.5 million deaths up to 2,030. Next, please. As conclusion, we have demonstrated not just us, but many studies around the world have a substantial impact of ODA in reducing adult and child mortality over the past two decades, especially for poverty-related conditions. And multiple independent studies also have demonstrated how the current abrupt reduction in ODA funding is already contributing and will continue to contribute to millions of avoidable deaths in the coming years. Welfare distribution policy could represent an important instrument to mitigate that, saving tens of millions of lives in the years ahead.
Barry Andrews
Thank you, David. That's very good timing and very clear presentation. And, you know, overall, what you're saying is that aid works and cuts cost a lot. So that's very clear. Right.
We'll now give the floor to Yukiko Nakatani, doctor Nakatani from the WHO who's joined us remotely as well. So, Yukiko, if you can hear us and see us.
Yes. I can see you.
And then, yes, you have the floor for 4 to 5 minutes, doctor Nakatani. You're very welcome.
Yukiko Nakatani
Thank you very much, honorable chair, distinguished members of the European Parliament. Thank you very much for this opportunity to address you on behalf of the World Health Organization. First, a special thanks to you, to the European Union and its citizens. You are the world's largest provider of official development assistance. Your leadership and the commitments have saved many millions of lives and remain the lifeline to most vulnerable peoples.
As we heard from Professor Roussella, the evidence is clear. Development aid saves lives. Aid cuts are significantly placing lives at risk. I will speak on how this is affecting countries and the WHO. So we estimate global health age fell 30 to 40% in 2025 compared to 2023.
Many countries already faced longer-term structural constraints, high debt burdens, and insufficient domestic financing. Aid cuts are worsening this health financing emergency. We see this especially in Sub-Saharan Africa where many countries' health systems rely on external aid. External resources often exceed the domestic public health spending in some countries by as much as 3 to 1. Honorable members, sudden AIDS cuts have a real impact.
Last year, they caused disruptions to essential health services similar to those during the peak of COVID. They helped access to the health saving, lifesaving medicines. They left children without immunization and women without safe maternity care. They left health workers uncertain about their salaries. They undermined core system foundations such as the data and information, planning, and budgeting on which all health care depends.
Cuts hit especially hard in the humanitarian settings, where urgent needs are often greatest. They have affected operations of close to 6,000 health facilities, with more than 2,000 forced to close. Over 53 million people have lost access to the essential health care. Two million women have lost access to critical health services, and 14 million children may lose access to the nutrition program. Mental health services have collapsed.
Disease surveillance is at risk. WHO has also faced tough challenges. We have reduced our workforce by around a quarter. In the meantime, we sharply focus on essential core functions which others cannot do, such as the normative functions to ensure quality of health products, and also the leadership role to convene all relevant stakeholders to facilitate better coordination to be able to maximize impact in public health. Honorable members, at the time when global health needs are growing, the world depends on the WHO's ability to respond effectively to member states' needs.
We are working closely with the European Commission and the other partners to help countries transition towards sustainable domestic health financing. The UHC partnership, our flagship health system collaboration with the commission, is a crucial vehicle. We are providing urgent guidance to countries on health financing reforms. Meanwhile, the humanitarian community has embarked on a humanitarian reset to prioritize in the face of constrained resources. WHO is fully engaged in this per process.
WHO is also bringing together our own member states and global health institutions for a crucial discussion on the future of the global health architecture. Together, we must ensure institutions and actions to build and do not weaken country ownership and health sovereignty. And the forthcoming EU global health resilient initiative can play a vital role in strengthening our collaborative efforts. Honorable members, let me close by reinforcing how you can help. We count on you to help ensure the European Parliament's sustained commitment to global health and cooperation, including as a powerful long-term investment in Europe's security, stability, and resilience.
We invite you to protect predictable multiyear funding for global health and humanitarian action in the next EU budget to help safeguard WHO's core global function and country support, to promote a stronger and more coordinated multilateral health ecosystem. Together, and with your leadership, we can protect health gains and ensure the global health cooperation that rises to the challenges ahead. I thank you. Go back to you, chair.
Barry Andrews
Thank you, doctor Nakatani, for your intervention. And now we'll open the floor to members for comments and questions, and we'll start with the EPP. On behalf of EPP, is Niels Goyking. Niels, have the floor for two minutes. Yeah.
Niels Geuking
Thank you very much. If you now go forward.
Thank you very much, Jeff, and thank you for those contributions. Obviously, in development aid, it's always important that we do bear in mind that we have to make our effects and our activities visible, because one of the problems we have that is in development, we always see that we're the first place they look to cut the budget. And we've seen this over decades. And once again, we're seeing this issue in a number of member states where the budgets are under pressure. So I think we need to bear that in mind.
On or we need to do, I think, is understand we the less money we have at our disposal, the more efficiently we have to use that money. And that begs the question, it's important to have facts on the ground to see how we can use money better in the future. After my delegation trips, I often hear from people on the street, please get some European companies in. They're not just better employers vis-à-vis Chinese, for example, and other countries' companies, but it also means that society becomes more resilient because they have better jobs, and that helps independence and autonomy. So at the end of the day, I'd be interested in knowing how we can promote the independence of populations because development aid is an initial approach.
It's something to be built on to allow local populations to be independent later on. So we provide support so that these countries are more resilient and stronger. When it comes to health issues, yes, the shortfall that we see because of the withdrawal of the Americans is massive. We can try and close that gap as much as possible, but it is true that it's not easy to mobilize the money that we need to the extent we need it. And hence, I'd be interested in knowing where you see an approach that might be effective.
Because we see that people are dying of diseases that are preventable. This is something that should mobilize us and motivate us. And even if fewer people are dying, people are still dying. So what is the best leverage you can exert in your experience to reduce mortality? Thank you.
Barry Andrews
Thank you, Niels, for that intervention. And now we will go to S and D. And it's Lera. Is it here? Lera Perin for S and D.
Leire Pajín
Two minutes. Thank you. Thank you, chair. Muchas gracias, presidente.
Thank you to the chair and to the secretariat for this very opportune debate. Thank you very much to the experts for shedding light on this and giving us data. This is really opportune, as I said. Just a few days ago, we got the report of the OECD on the last few years. And in 2025, there was a cut of 21 percent in this aid.
And especially at the time, as the chair said, where the narrative is being constructed to justify these cuts, which is why it's good to talk about data in a precise manner. And today, we've seen how much aid there is, and the impact of this aid. ODA has reduced mortality by 39 percent of global citizens. So it is a useful tool to reduce mortality. And its absence, however, will lead to concrete deaths.
And we saw this here very closely with the scientific methods. It has been shown that this could lead to 21.6 million people could die. So what are we talking about? Human lives and this investment or lack of investment that costs millions of lives. Also, there needs to be security in global health. Not only is this a moral crisis, but it's also putting all of us in danger, taking us backwards with regards to HIV, malaria, tuberculosis, etcetera.
And we really should use many tools to deal with this global gateway, should strengthen prevention, research, and response activities of health in southern countries, and then Horizon Europe should be used to strengthen research in countries of the South. And we should clearly work with concrete investments in resilience of countries in the area of global health. So, experts, I would really like to ask you, what are the concrete objectives that you're expecting from the European Union and this parliament? Where should we focus aid in the coming years in these areas? Thank you.
Barry Andrews
Happy to open the floor to any other members who wish to make a comment or pose a question. Anybody else? Mark, then Marco, then Muriel. No. He hasn't indicated yet.
So Mark Jungen, please have the floor.
Marc Jongen
Many thanks. I'm going to speak in German too.
Well, looking at the World Bank figures over the last 25 years, life expectancy in almost all developing countries since 2000 has increased. In some countries, quite significantly, in some of the poorest countries in the world, in Sub-Saharan Africa, the situation is much better than it was a quarter of a decade ago. We're see, sorry, quarter of a century ago. We're seeing that income levels are getting up to middle income country levels in many areas, but the disparities are still quite considerable, which means that the narratives behind the improvements, are they actually substantiated? Is the development aid making a difference?
We see that Sierra Leone, for example, has a high level of money being spent from developing aid, but we saw a very low level of increase in life expectancy. In other countries, we can see improvements up to 18 years. In child mortality, we see a similar picture. There's improvement across the board, but a clear link to development payments we do not believe to be prevalent. Many things speak in favor of a stable central government helping peace, regardless of the direction in political terms that government takes, is much more decisive.
Hence, my question to the experts. How can the EU spend its money in the most efficient way to save lives and increase life expectancy? Is the best approach not to work on ensuring peace regardless of democracy or democratic capabilities of any country, and to make the worst situations a bit better rather than using a watering can principle?
Prince, please.
You have.
The floor.
Charles Goerens
Thank you. Thank you for the assessments that we've heard about the impact of the decline in ODA. I mean, this really shows us that we must take responsibility for some of the poverty and suffering around the world. I mean, we have these commitments. We keep making these commitments, but we don't stick to them.
We announce something, and then we don't do this. So we have this very heavy responsibility, which is a jewel in nature. First of all, we have to step up here in Europe. I mean, member states really don't care about this. Let's call a spade a spade.
With a few exceptions, the levels of commitment announced are not followed up on. One can use the pretext of certain sums having been spent without any tangible result. I mean, that's no doubt true. That's true in all policy areas. But we cannot shirk our responsibility and hide from reality.
We are responsible for the impoverishment and suffering among the most vulnerable. Everything that we do in development policy can have a positive impact on our countries, and I would agree with the previous speaker in that regard. But I think that it is important that states be assisted to get out of their poverty trap. They need to make efforts themselves, but that's not enough. I mean, there's an interdependence or an interaction.
There has to be an interaction between what we do and what developing countries do. About fifteen years ago, when the Ebola epidemic started, we saw that in Liberia, in just two or three days, the health care system was completely helpless. On the other hand, a country like Nigeria that had a significant development of its health care system was able to bring the crisis under control to more or less the same extent as many European countries. They had a system of laboratories for providing health care and so on. So I don't think that we can just sit back and consider that it's sufficient to mention some poor examples.
No, our challenge is not to fill in the deficit created by the stepping back of The United States, but rather we must make sure that we apply a multilateral approach to combating epidemics and to dealing with crises. And that is a European responsibility without, PROVERA.
Barry Andrews
Of course, us being able to fill in all the gaps left by those who are not keeping their promises. Marco, then Muriel. Marco Torquino, you have the floor for one minute, please.
Marco Tarquinio
Thank you. Thank you, Chair. Well, I would agree with what was said by our colleague Parin. And I think that this problem that is emerging means that we need to take advantage of an opportunity to better take advantage of local resources and what is locally available. Now international organizations note that there are substantial resources available for health care in countries of origin.
We need to apply the interdependence approach that has been mentioned. But in fact, there is a distortion in the sense that much of our health care system is, in fact, being used for dealing with asylum seekers and refugees. But there is sort of almost a deliberate or a preannounced genocide. I mean, cutting back on health care support as is being done by the United States of America. I mean, this is a political act.
This de financing, in fact, amounts to that. And having de-financed the health previously provided, that has, in fact, resulted in a substantial increase in the number of deaths.
Thank you.
And, Marielle, you have the floor.
Murielle Laurent
Thank you. Thank you, Chair, and thank you very much to the speakers for their assessments, for the studies that they have presented to us, for the figures. Now this work and the results from the scientific literature show that there is a direct impact in terms of reduction of ODA over the last twenty years. But the more recent figures of the OECD and the colleague, Payne, has mentioned this show that there has been a historic and a very substantial reduction in ODA in 2025. A number of countries, including France, are reducing their ODA, and that is having the greatest impact on the least advanced countries where the needs are greatest.
And in terms of world health care, that means that we are regressing. Aid is being concentrated on economic and geopolitical areas rather than the human needs that need to be supported. And as we negotiate the next MMF, we need to look at this carefully in order to make sure that we don't end up with sustainable deleterious consequences.
Barry Andrews
Just to add, we will come to DG NPA and DG ECHO in a moment, and then back to our guests. But just a couple of points from my side. I mean, I think that if we in this room came up with a policy that saved 4 million children's lives between now and 2030, we would be getting the Nobel Prize. In fact, what we have is a policy intervention that's not happening, that's causing this four million. And we know what the solution is.
It's just there. We can just make that choice. Problem is, while there are massive human costs, there's zero political cost, and nobody really is objecting to the mass productions. There's no public movement. There's no response from the public on this issue, and therefore, these costs can be made.
So, look, I just have specific questions. Namely, your study looks at mortality, but doesn't look at the incidence of disease that might be a result from these cuts or, you know, morbidity as it's described, or stunting or wasting among children. Are you planning to look into these, sort of not secondary consequences, but these other consequences of the cuts, in future studies, or have you already thought about that? Secondly, and just building on Marco's question, you know, are you just looking at the volume of ODA that's left, or are you getting into a bit more granular detail? Because in a lot of countries, what counts as ODA includes things like migration management.
UK is spending more on UK migration management in the UK than it spends in all of aid in Africa. And, also, are you looking at the quality of the aid, you know, where some of it is now used to support investment protection in middle-income countries? And, you know, have you got into that detail, in terms of how it's now allocated, in order to inform the outcome of your studies? So with these questions, I'm going to now hand the floor to Miss Cecile Bilod, who is the head of unit of DG INPA, social inclusion and protection, health, and demography. So Cecile, you're very welcome, and you have the floor for three minutes, please.
Cécile Billaux
Thank you very much, and good morning, 100 members. And thanks for organizing this debate and for getting this important data and analysis of what indeed ODA can bring in the area of health. Very essential to be reminded of that, especially in today's context. Just to recall a little bit on the EC, European Commission front, where we are in spending aids, and because this was not also in the slides. So some of the donors, very important for our member states.
But as regard to the EU, we have so far under this MFF, so 2021 until 2025, until last year, spent EUR 6,000,000,000 approximately, a bit more, on global health, which is still remaining. We haven't decreased our level of funding. This is still remaining, and this is still stable. Half of it goes towards global initiative, WHO and global health initiative, which, of course, triggered on inter country level also. And the other half is direct program we do at the regional and country level.
Just also to recall that last week, our commissioner was in Lyon for the One Health Summit, which was organized under the French presidency, which was an important moment also on health, to get the political momentum there. And in particular, we also announced the figures for the global funds, so remaining the EU to keep a stable contribution to the global fund for AIDS, malaria and TB with an intention of €700,000,000 across the two MFF. And under this MFF, euros 185,000,000 committed. And then also to recall that we are working at the moment towards the adoption of the Global Health Resilience Initiative, which is foreseen on the college agenda for May, which will be really important to recall and reaffirm also the EU role in global health, what we do and what would be the priority in today's context in a resilience sort of mindset. Yesterday, the call for evidence ended, and we gathered more than 180 contributions, which was really good and welcome.
So we analyzed and put something on the table for adopting the Global Health Resilience Initiative. And also, just commenting on some of the comments that have been done also with some of the members. Indeed, this is also the opportunity of seeing ODA decreasing, of also refocusing and trying to look at efficiency and what is called reforming the global health architecture, meaning not decreasing the commitment that we have at global level and to multilateralism, and to think that works, but trying to do it in a more efficient manner. And that's really how we best use the ODA. And I think these efforts are going on.
WHO is at the center of its efforts, with now a joint process being launched next month in the WHO. And this will be, of course, very important also to make, again, the best use of ODA and to try to see how we kind of minimize the risk and the decrease in terms of public health outcomes that we outlined in the study. Thank you.
Barry Andrews
Thank you, Cécile. And now we give the floor to Ms. Barbara Decans, DG ECHO. Barbara, you're welcome. You have the floor for three minutes.
Barbara Dequenane
Thank you, and good morning to all. And thanks to Professor Rasella for making this presentation and for setting the scene, that comes at a very crucial time. My colleague has just mentioned that INPA has remained a reliable donor in the health system. I would like to say that it's the same for humanitarian assistance. The commission has remained a reliable donor and has remained needs-based and principled.
In 2025 alone, DG ECHO has allocated €400,000,000 to health interventions, so that's about one fifth of our yearly budget, and it's an all time record. We have intervened in countries such as Syria, Palestine, Afghanistan, Yemen, Sudan, Ukraine, and Venezuela, and of course, in many other countries. But as was discussed, humanitarian aid alone won't be enough. The Lancet study points at an ODA funding for health system strengthening that has dropped from 19% to 7% since 1990. And we need to put back the health system on the table with a more efficient approach, including preparedness and targeting fragility, and encompassing humanitarian aid, development aid, and national capacities to foster health resilience in the long term.
The commission communication in humanitarian aid, and what Cecile mentioned, the Global Health Resilience Initiative that will be launched next month will crucially work in this direction. In the current hyper-prioritization of aid, mortality data is not just a statistic. It is the key indicator of crisis severity to help determine the scale and urgency of the response, and it is the ultimate measure of whether our aid system is impactful and effective enough. Unfortunately, mortality data collection and analysis is also a victim of funding cuts. For this reason, DG ECHO has stepped up to fund the mortality estimation initiative that is led by Save the Children for the next two years, that will improve data collection and analysis, build the capacity of humanitarian actors, and foster the use of mortality data in decision making backed up by a strategic plan and an international governance structure.
Barry Andrews
Okay. Thank you very much, Barbara. And we will now go back to our guests. And, yeah, I mean, you've presented us with a very, very compelling evidence, but there is a huge fatigue among the general public and, at high political levels about these startling revelations that should create a massive backlash publicly, but they don't, there is a changing mood around these issues. But let me put the floor back to professor Racella, if you can hear us and see us, to reply to some of those comments.
Davide Rasella
Thank you very much. Very brief. We are expert on, I'm expert in the group I'm leading in global health. So we reply more related to that. But, of course, things can be reformed.
ODA can be reformed and should be reformed. And I think in the long term, the idea of decolonization is inclusive and depends on sufficiency and dependency of the low developed countries is expected, of course. But the problem of what is happening now is how abrupt and how significant these cuts are. The majority of them have not been planned. There are no guidance, no transition strategies behind them.
And this is when you leave, you cut health care to vulnerable population, when you cut food support to malnourished children or HIV treatment to patients with AIDS, or education for poor children. Of course, you will have consequences and, unfortunately, dire consequences. As I told you, it's not just our group showing this statistic of million and million on death, but many other groups, many other studies are showing that. So, really, the problem is not necessarily reducing the ODA, but how we do that, in how much time we do that, which, you know, you should really have a transition strategy. Regarding which are the most cost effective, of course, in terms of health, probably focusing on health care will be the most, you know, cost effective, but food supply, of course, education, sanitation are also extremely important. It's very difficult for us to understand that.
So, really, the idea can be, and maybe this is a proposal, to really spend the next years understanding how to develop a transition strategy, how to reduce, yes, this support, but in a very clever way, a more efficient way, and not in a so dramatic way that is costing legal of lies. Of course, the importance of governance. We have done studies also showing that. We have stratified this analysis with governance. Of course, the countries with better governance have the strongest results in terms of efficiency of the ODA.
But, of course, we cannot completely abandon the ones with lower governance because, after all, they are the most vulnerable. So, really, we can't leave the population alone. We are also studying the impact on the incident of some diseases. As I was showing, the mortality from HIV, AIDS, from tuberculosis, and malaria is particularly affected by ODA, but we are trying to study also the incidents. We have some interesting results on wasting and stunting.
We have demonstrated that ODA was able to reduce 50 percent high level of ODA, 50 percent the level of wasting acute malnutrition on children in low and middle income countries, and 20 percent stunting. So, really, it's not just mortality. Of course, they are acting on the different natural disease pathway up to mortality. And in terms of ODA, we actually used, we selected an indicator more related to health and health care. Determinants of health, of course, but we excluded in our studies ODA related to, you know, asylum seekers in the northern countries.
Okay? How to evaluate the cost effectiveness of the specific sectors, the specific interventions, and the allocation of the AMOR in general, this will require more time. And so I think, really, that what we are presenting here with this data is the enormous damage and the terrible consequences of this. Unfortunately, I will not say policy, but I will say the tendency that we are having of reducing so dramatically, so abruptly without majority of the time, without a transition strategy, this life support ODA in the most vulnerable situations. This is clearly.
Thank you, David.
Davide Rasella
But, of course, now we, as experts in global health, we think that it's important to design transition strategies. And there are many arguments.
Barry Andrews
Sorry, Davide. I really apologize. We're a little bit over time. So we'll finally give the floor to Dr. Yukiko Nakatani. If you could be very brief, Doctor Nakatani, closing remarks.
Thank you.
Yukiko Nakatani
We have to invest where is the priority, we have to support in the country to strengthen the health system. So let me emphasize again the importance of the invest and the support for the health system strengthening, including the key important fundamental function, which is the health finance and the data and the health governance, including the health workforce. Because this investment to the health system also contributes to the economic growth through securing the job opportunity for the health workforce, direct and indirect. This is also important to ensuring the domestic financing and then more sustainable health system in those countries. Then also, importantly, we work on the strengthening partnership, including the broader donors together, and then we are going to discuss the future architecture reform.
This is also important to facilitate better coordination to reduce the duplication, and then we can maximize the impact in a more efficient way. So this is only a way we can continue to support the country. So the EU's leadership through the UHC partnership is very important. It's crucial to engage all the stakeholders on the same table to discuss this architecture reform to a more vital way. And also, and lastly, I would like to mention for the health information system, is this also a fundamental function of the health system to be able to monitor the mortality, monitor the progress on the improvement of the health care services in their country, and also engage with the policymakers how important to invest in those areas.
May I.
Barry Andrews
I'm afraid we ran out of time, doctor Nakitani. So we really appreciate your contribution, your interventions, and indeed that of doc professor Rasella. So, members, we will take this information. Hopefully, it's pretty extraordinary, and help us to develop the correct narratives around what we're
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