Health

In developing countries, illnesses often plunge entire families into crisis because they usually have to pay most the costs on their own. And every year, around 100 million people fall into poverty because they have to spend what little money they have on medical care or medicine. Illnesses and the high costs of treatment are one of the most common causes of poverty worldwide.

Consequently, the goal of development cooperation is to contribute to universal health coverage (UHC) in the event of illness. A sustainable financial system that generates sufficient funds through tax revenue, contributions and supplementary payments is needed along with suitable health care services. The costs of treatment may not exclude the poor.

KfW Development Bank supports its partner countries in different ways in order to organise their health sectors to ensure long-term and stable financing. It promotes, for example, results and demand-oriented approaches in addition to funding for medicine, equipment and infrastructure ("inputs"). One example is voucher systems which provide good and affordable care to pregnant women and their newborns before, during and after childbirth. Furthermore, KfW supports the setup and expansion of health insurances as well as other health protection approaches. An effective approach proved to be including private health care providers so that more poor people can take advantage of medical services.

Healthcare financing is also an important aspect under what are known as programme-based approaches. In these models, KfW supports partner countries in structuring, budgeting and implementing their healthcare policy and thus strengthening the healthcare system overall.

A well-functioning healthcare system also needs the right infrastructure, equipment and logistics. People in developing countries often live hours or days away from the next medical facility. And, if they do make it to a health centre, it is usually not even close to meeting the highest standards in modern medicine. As a result, KfW Development Bank not only builds new hospitals and health centres, it also modernises existing ones on behalf of the German Federal Government.

One of KfW's priorities in the construction of new hospitals is sustainability. Under the heading "Green Hospital", processes and medical equipment as well as the building's shell and heating technology are optimised to use resources efficiently. Sustainable use of the new infrastructure also requires a sufficient budget, regular maintenance and enough staff with the right training.

In addition, KfW helps its partner countries set up cold chains to supply medicine or outfit labs with special equipment, for example, to diagnose tuberculosis. These are very often lacking particularly in poor areas. Innovative technologies like e-health create new opportunities in the healthcare sector: more and more people in developing countries use modern means of communication such as mobile phones and Internet that give them access to health information and services. Healthcare has been noticeably improved in remote areas and crisis regions as a result. KfW is also active here.

Around the world, some 10,000 infants die each day from malaria, AIDS, tuberculosis, diarrhoea or childhood diseases that could easily be prevented by vaccines. About one-sixth of the world's population suffers from tropical diseases that have been difficult to treat so far, such as dengue fever or sleeping sickness. The healthcare systems in many of our partner countries cannot cope with these illnesses on their own.

As a result, KfW Development Bank has provided support in the fight against tuberculosis and polio at national and international level for many years by financing vaccines, cold chains, supply systems and laboratories for diagnostics and to control epidemics. India, for example, has been supported in its efforts to contain polio by KfW since 1996. In the meantime, the World Health Organisation has certified India as polio-free. In Nigeria, KfW also promotes intensive vaccine measures, even though polio is not endemic anymore since 2015; the plan is to vaccinate more than 25 to 30 million children against polio every year.

Together with the GAVI Alliance, KfW also supports vaccine programmes in the East African Community including the respective supply chains and helps prevent serious respiratory infections and diarrhoea which are two of the most common causes of death among children there. Overall, KfW supports programmes to fight diseases at a volume of more than EUR 412 million (without HIV/AIDS).

On behalf of the German Federal Ministry of Education and Research, KfW Development Bank has also fostered what are known as product development partnerships (PDPs) since 2011. Since then, EUR 26 million has been dedicated to the development of medicines, vaccines and diagnostics for neglected infectious diseases. This includes the fight against sleeping disease transmitted by the tse-tse fly or dengue fever, widespread mainly in tropical regions, which still affects millions of people every year.

Project information - Global Fund

The concept of reproductive health was coined at the World Population Conference in Cairo in 1994 and is inextricably linked to fulfilling and respecting human rights, including the right to information about and access to safe birth control. Although maternal mortality rates have been cut in half, 303.000 women died from preventable complications during pregnancy and childbirth in 2015. And more than 225 million women do not have access to contraceptives even though they don't want to become pregnant.

This is why one of KfW's priorities in the health care sector is sexual and reproductive health, which makes up 40 % of the projects in this sector. These projects include measures for safe pregnancy and motherhood, medically supervised childbirth, self-determined family planning and the prevention of female circumcision, HIV/AIDS and other sexually transmitted diseases. KfW, for example, supports projects that combine HIV prevention and family planning because the two are closely linked.

To this end, KfW Development Bank relies on proven instruments such as "social marketing" or "social franchising" that complement public family planning programmes and effectively help prevent HIV/AIDS on a wide scale. Both approaches make use of modern marketing and communication methods to promote healthy habits among the population. This includes the use of contraceptives and condoms, as well as taking advantage of health services. These services are offered to be easily accessible and affordable. "Voucher programmes", which entitle holders to supervised births and pre- and post-childbirth care for mothers and newborns, have also proven successful.