This is a joint post with Rachel Silverman.
Through our Value for Money working group, we’ve spent much of the past year immersed in the world of global health funding agencies. With so many new agencies, particularly in the last quarter century (Figure 1), understanding the intricacies of the global health family can be daunting, even for the most devoted observers.
This is a joint post with Kate McQueston.
Mobile applications – or ‘apps’ – seem to be the latest craze in mobile technology for global health programming. The proliferation of these apps is converging around a growing interests in open (and big) data, so you don’t have to look far to find creative ways they are being used to collect and display data in the development sector.
In recent weeks, the public health world and political pundits alike have been abuzz about results from the “Oregon Experiment,” a study published in the New England Journal of Medicine that finds no statistical link between expanded Medicaid coverage and health outcomes such as high cholesterol or hypertension. Limitations of the study aside, the Oregon Experiment is a good example of the importance of rigorously testing all US health programs, rather than just assuming ‘more care = better health’. The Innovation Center at the United States Centers for Medicaid and Medicare Services, created under the umbrella of the Affordable Care Act, represents a new and encouraging approach to address this problem, an approach that we think has important lessons for global health.
The New England Journal of Medicine recently published the results of “the Oregon experiment” based on the 2008 US Medicaid program expansion in Oregon. The study is one of very few randomized control trials on publicly-subsidized health insurance that exists to guide health policy, and found what some commentators considered a disappointing result: while health care utilization increased and households were protected from financial hardship, expanding Medicaid coverage had “no significant impact on measured physical health outcomes over a 2-year period.”
The World Bank’s Africa Health Forum: Finance & Capacity for Results during its 2013 Spring Meetings brought together ministers of finance and of health from 30 African countries in a unique opportunity for mutual listening between countries and partners. One recurring theme in forum and in the first panel was that results-based financing (RBF) – where financing is conditioned on achievement of results in health – is a key approach to driving value for money. In short: RBF = more money for more health. (You can watch the recorded ministerial discussion here.)
Immunization saves millions of lives, is among the most cost-effective health interventions ever developed, and has attracted a great deal of attention and funding from public and private donors in recent years. Indeed, global health leaders have committed to making this the ‘Decade of Vaccines’ with the vision of delivering universal access to immunization by 2020, and the World Health Organization has put out a Global Vaccine Action Plan (GVAP) to serve as a blueprint to achieving this goal.
The Global Fund to Fight AIDS, Tuberculosis, and Malaria recently announced an ambitious goal of raising $15 billion in its fourth replenishment later this year, of which they hope the United States will contribute one-third ($5 billion, or $1.65 billion a year for three years). So I was interested to see these two sentences tucked into the White House’s 2014 budget request:
Alongside Victoria Fan, I recently attended the Evidence Live conference in Oxford, hosted by the BMJ and Oxford’s Centre for Evidence-Based Medicine (CEBM). While the conference’s clinical focus was outside my normal global health/economics comfort zone, I was immensely impressed by the rigor, candor, and nuance of discussion, particularly around tough issues like publication bias and conflict of interest.
At a panel session during the 4th Conference of the Consortium of Universities for Global Health (CUGH) held in Washington, DC, a group of distinguished speakers and leaders on health in China – from the China Medical Board, top universities and the Ministry of Health – were tasked with discussing and elaborating on China's role in global health. The speakers briefly discussed China's history in international health activities (their first deployment of medical teams to Africa dates back to 1963!), different kinds of partnerships in global health - particularly among universities, and examples of current and upcoming initiatives. In sum, the panel suggested a promising future for China’s role in global health.