As a result of the Millennium Declaration, the past decade has witnessed a surge in development aid. Overseas Development Assistance (ODA) rose from USD 2.9 billion in 1995 to 14.1 billion in 2007. The decade has also seen a proliferation of donors including bilateral, multilateral and private foundations. This is also true for funding for health, including sexual and reproductive health. Today there are over hundred global health initiatives (GHIs), seven of which are related to sexual and reproductive health. While these increases in funding for health are encouraging, they fall short by half of what is actually needed to achieve universal and equitable access to health care and services.
In 2003, donor and recipient country representatives met in Rome to discuss better harmonisation of aid and subsequently in 2005, with concerns over the effectiveness of AID delivery and management, the Organisation for Economic Co-operation and Development’s Development Assistance Committee (OECD DAC) organised the High Level Forum on Aid Effectiveness in Paris. The outcome of the forum was the Paris Declaration (PD), which was based on five principles: ownership, alignment of aid based on development priorities, harmonization of aid, managing for results, and mutual accountability. Following the Paris meeting, in 2008 a review of the progress of the PD was done in Accra. Despite these efforts, development funding has been critiqued severely on many grounds, which include lack of coordination, influencing priority setting and their own lack of accountability, and that most funding goes back to Northern donor country as administrative costs, consultancy and contractual fees, leaving little for the developing countries critically needing that aid. Then again, questions are raised as to whether there will be an increase in financial fund flowing to developing countries or if they will at least be maintained at the current levels given the food, fuel and financial crises globally.