[Effectiveness of official development aid and new principles and tools for health development aid. 2008 SESPAS Report].

Years after its inception, the results of official development aid in terms of poverty reduction are still limited. Among the causes, especially in the health sector, are aid dispersion and its divergence from priorities and mechanisms of recipient countries' public policies. The Paris Declaration of the High Level Forum on AIDS Effectiveness (2005) fostered an agreement on the principles to be adopted to improve the effectiveness of aid by strengthening recipient countries governments' leadership of the aid and reducing aid delivery transaction costs. Aiming at these principles, the use of new instruments -programmatic instruments- and new approaches - the sector wide approach- are being promoted to increase the effectiveness of aid. Despite some weaknesses, the assessment conducted on their utilization seems to show better performance than that achieved with traditional instruments. Spain joined the Paris Declaration in March 2005 and incorporated the use of programmatic instruments and the participation in sector-wide approaches in its new Cooperation Policy, thus initiating a significant change from previous strategies that mainly encompassed project implementation and technical advice. The new strategies directed at strengthening public policy in recipient countries provide an opportunity to increase the effectiveness of aid; however, major changes are needed for their implementation.