The United Kingdom was once seen as a global leader in the provision of development assistance for health. The UK was a major contributor in areas such as maternal health, polio eradication, and inclusion of people with disabilities.1 Along with the Nordic countries it was one of a handful that had reached the United Nations target of spending 0.7% of gross national income (GNI) on development assistance and it was widely praised for its emphasis on evidence informed approaches, transparency, and accountability.
However, this reputation has been tarnished since 2020, when the then government cut spending to 0.5% and—in a highly symbolic act that signified the subordination of development assistance to the national interest—moved the Department for International Development (DfID) into what became the Foreign, Commonwealth and Development Office (FCDO). An increasing share of the budget was diverted from spending overseas to support the growing number of asylum seekers in the UK, increasing from 3.2% in 2016 to 28% in 2023.2
There is a clear moral argument for providing development assistance to alleviate poverty and ill health in poorer countries. However, for many politicians the more compelling arguments—stronger than ever in an increasingly unstable world—are pragmatic. A paper signed by Rishi Sunak and his colleagues in the FCDO sets out the many ways that development assistance helps achieve the UK’s other policies.3 Migration is featuring prominently in the election debates and development assistance is needed to tackle the conflicts, poverty, and consequences of climate change that drive so many people to flee their homes. It creates new markets for British goods and services by fostering economic growth in poorer countries, and it gives the United Kingdom soft power to enhance its influence on the world stage. It can deliver long term cost savings by reducing the need for emergency humanitarian interventions, military engagement, and other costly measures associated with global crises. So, what have the main political parties said about development in their manifestos?
The first question is how much do they propose spending? There are clear divides. The Liberal Democrats would return to the 0.7% figure and re-establish an independent international development department.4 Labour and Conservatives state their intention to return to the 0.7% figure, but only when the financial conditions allow it.56 However, neither give any indication in their manifestos of what would need to happen to allow it.
The Green Party is the most ambitious, setting a goal of spending 1% of GNI by 2033, with a further 1.5% of GNI spent on climate finance.7 The Greens would also contribute to the new Loss and Damage Fund established at COP27 in 2022.8 This is intended to help vulnerable countries to respond to increasingly severe storms, floods, and rising temperatures. The Conservative government has contributed £60 million to this fund already, but as Save the Children has noted,9 this is a repackaging of existing spending commitments. The Conservative manifesto does, however, commit to support for small island development states, especially those in the Commonwealth, helping them to access finance for climate change adaptation and resilience. Labour has previously supported this fund but, while referring several times to the UK’s squandered global leadership in this area, suggests that it will regain this position mainly through domestic initiatives.10 In marked contrast, Reform UK would cut the development budget by 50% to pay for some of their expansive and populist domestic spending commitments11 but, as organisations such as the Institute for Fiscal Studies have noted, the sums in their “manifesto do not add up.”12 Given Reform’s leader Nigel Farage’s longstanding rejection of the global consensus on climate change,13 it is unsurprising that the Loss and Damage Fund gets no mention in the Reform UK manifesto.
The second question is what the parties would spend the money on. The strategic focus of the UK’s support has shifted since 2000. Under the last Labour government, it was closely aligned to the Millenium Development Goals and debt relief, prioritising the poorest countries. Under the subsequent Conservative and Liberal Democrat coalition government, in power from 2010 to 2015, there was an increased emphasis on aid effectiveness and transparency, while a series of crises, including Ebola, led to increased spending on humanitarian emergencies. Since 2020, Conservative policy has been shaped by the post-Brexit Global Britain agenda, with its emphasis on security, trade, and science and technology,14 and the demands created by covid-19.
The Conservative manifesto emphasises the use of development assistance to promote the national interest, including support to fragile states, the sources of many of the migrants who have proven so politically contentious. However, it also commits to support for the Sustainable Development Goals. It includes pledges in specific areas, including global health, girls’ education, reproductive health, and campaigns against human trafficking, modern slavery, and female genital mutilation. It also would continue to support measures to tackle antimicrobial resistance.
Labour would also ensure that its development programme aligns with its foreign policy objectives, specifying plans to tackle global poverty, instability, and the climate and nature crisis. Its mission statement is “to create a world free from poverty on a liveable planet.” It would focus on economic transformation, debt relief, women’s empowerment, conflict prevention, and climate finance, while ensuring value for money through transparency and scrutiny. It would also strengthen support for refugees and tackle the humanitarian crises that cause people to flee. It does not propose recreating a separate international development ministry. This could be seen as surprising, given that the creation of DfID by Tony Blair in 1997 is widely considered to have been one of his major successes.15
The Liberal Democrats would focus on human rights, gender equality, climate action, and poverty reduction. They would spend 15% of the aid budget on education, focusing on girls and young women. They differ from the Conservatives and Labour in their proposal to use trade policy to advance human rights, citing the Magnitsky principles adopted by the United States in 2016, although the British government has already enacted a similar law and used it.16
The Green Party has traditionally taken an internationalist approach, reflecting the global nature of the issues it prioritises and its involvement in a global movement. Underlying its proposals is a commitment to empower the Global South and tackle historical injustices. In addition to its support for the Loss and Damage Fund, it would establish a Parliamentary Commission for Truth and Reparatory Justice for trans-Atlantic slavery reparations. It would also promote sustainable economies in low-income countries with finance and technology and collaborate with other countries’ debt relief.
Finally, Reform UK argues for better targeting of development assistance and would not provide any funds to China or India and promises a major review. However, it is not clear how this will be achieved given that what is provided to these countries flows largely through multilateral organisations. Nor does it indicate any familiarity with the UK’s partnership with India, with its emphasis on investment in that country’s private sector.17
It doesn’t seem likely that the next parliament will manage to restore the UK’s reputation as a leader in development cooperation as the issue has not featured prominently, if at all, in the election debates. But the scale and orientation of the UK aid spending will vary widely depending on which party gains power.
Development is not included in the list of issues that the public might consider important according to YouGov’s tracking polls.18 This seems surprising given that development assistance is an essential element of effective responses to many of the issues that the public do consider important, such as migration, economic growth, and the climate emergency, now impacting substantially on the UK’s agriculture sector.19 It seems that politicians and the media are failing to join the dots. We in the public health community must do more to make those connections to help foster a more equitable and sustainable world.
Footnotes
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Competing interests: Martin McKee is Past President of the European Public Health Association and British Medical Association.
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Provenance and peer review: commissioned, not externally peer reviewed.