Spending to improve health in developing countries has continued to grow during the three-year economic downturn, although at only half the blistering pace it did a decade ago.

As increases in spending by “donor countries,” such as the United States, have slowed, the World Bank has picked up up the slack, lending large amounts of money to middle-income countries, in part as a way to counter the effects of the recession. Recipient countries have also increased spending out of their own domestic budgets.

Overall, spending on malaria and child health problems has grown more rapidly in the past few years than spending on AIDS and tuberculosis. All have seen a net gain, however.

Those are among the conclusions of a new report assessing the effects of the global economic doldrums on foreign aid, development and charity aimed at improving people’s health. A short version appears in the journal Health Affairs.

“We were expecting to see a story that’s pretty different, an overall decline,” said Christopher J. L. Murray, head of the University of Washington’s Institute for Health Metrics and Evaluation, which produced the report. “What we’re seeing is a continued increase — albeit slower — which is a surprise.”

For the past two years, “development assistance for health” — the term favored by economists — grew an average of 4 percent a year. This kind of spending has more than doubled since the start of this century, from $10.9 billion in 2000 to $27.7 billion this year. During some of those years, there was double-digit growth.

From 2007 to 2008, for example, spending by wealthy countries and institutions on health problems in the developing world increased 17 percent. The current growth rate is about what it was in the 1990s.

The effects have been measurable, experts say.

This week, the World Health Organization said that annual deaths from malaria have fallen 26 percent since 2000, and now stand at 655,000 a year. Several weeks ago, the United Nations’s AIDS program reported that 6.6 million people in poor countries are taking antiretroviral drugs, up from 200,000 a decade ago.

Recent events, however, are worrying the global health community.

The U.S. government’s spending on global health has been flat at $8.9 billion a year for two fiscal years. Spending by U.N. agencies decreased 1 percent in 2011. In November, the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria, which supports treatment of 3.3 million AIDS patients, said it would not make any new grants for two years.

“It may be that it’s just coming,” Murray said of the effects of the economic crisis that started in September 2008.

Richard Feachem, the first director of the Global Fund and who now heads the Global Health Group at the University of California at San Francisco, called the advances of the past decade “fragile and quickly reversible.” He said he thinks “we are now in jeopardy of going backwards.”