Although counting the sick and dead in a country can seem quite dull if not morbid, these facts are critical inputs to designing any national health policy, let alone global priorities in health. Yet 85% of the world's population still lack systems that register births and deaths along with high-quality data on causes of death.
The US government spends about $6.4 billion a year on preventing and treating HIV/AIDS in the developing world, and 4.5 million AIDS patients depend mostly on US generosity each day for the AIDS medicines that keep them alive.
In this post, Gabriel Demombynes, Senior Economist in the Nairobi office of the World Bank, describes some of the issues raised at the Center for Global Development and the African Population & Health Research Center’s first meeting of the Data for African Development Working Group meeting last month. This blog was originally posted to the World Bank’s Development Impact Blog on October 1, 2012.
by Gabriel Demombynes
Recently I attended the inaugural meeting of the Data for African Development Working Group put together by the Center for Global Development and the African Population & Health Research Center here in Nairobi. The group aims to improve data for policymaking on the continent and in particular to overcome “political economy” problems in data collection and dissemination.
This is a joint post with Heather Lanthorn, a doctoral candidate at Harvard School of Public Health.
In mid-July, amidst the busy global-health month of July, in between the Family Planning summit and the AIDS conference, the near-final draft of the independent evaluation of the Affordable Medicines Facility - Malaria (AMFm) was released.
In this austere budget climate, generating “value for money” (VFM) is a top concern for global health funding agencies and their donors, who want the biggest bang for their buck in terms of lives saved and diseases controlled. To that end, CGD has convened a working group to help shape the VFM agenda with high impact recommendations for reducing costs, increasing impact per dollar spent, and focusing investments on the highest impact interventions among the most affected populations. Since our first meeting in April, we’ve been hard at work collecting evidence, consulting with global health agencies, and identifying the most promising areas for further investigation. The main funding agency under our VFM microscope: the Global Fund to Fight AIDS, Tuberculosis and Malaria.
A few days ago the World Health Statistics 2012 Report released its annual compendium of statistics. No doubt, it was a lot of work to compile—to verify every number in every cell, for each country and indicator. The WHO should be commended for providing this invaluable global public good. A sincere request: the Report would be more user-friendly and useful if the Report came with spreadsheets in downloadable tables (much like the World Malaria Report), and if the Report’s tables were consistent with their main database, the Global Health Observatory (GHO). For example, the coverage measures of oral rehydration therapy (ORT) which were included in the Report are absent from the GHO, as far as we can tell. (On an unrelated note, we did notice that the GHO recently added hand-washing as an indicator, perhaps in response to a recent blog—kudos to WHO!)
Recently, the American Journal of Tropical Medicine & Hygiene published a paper by Shepard et al. evaluating the impact of HIV/AIDS funding on Rwanda’s health system. The headline of the press release was catchy and assertive: “Six-year Study in Rwanda Finds Influx of HIV/AIDS Funding Does Not Undermine Health Care Services for Other Diseases. Study Addresses Long-standing Debate about Funding Imbalances for Global Diseases.”
A few weeks ago, the Independent Evaluation of the Affordable Medicines Facility – malaria (AMFm) Phase 1 evaluation was released by the Global Fund on its website. Much to my dismay, however, this “evaluation” was only the ‘Baseline Report’ on AMFm which provides basic information on the pre-intervention data, based on my quick read of the Executive Summary:
A recent study from the Lancet says that malaria caused 1.24 million deaths in 2010 (compared to previous estimates of 655,000), suggesting that the number of deaths from malaria globally may be twice as large as previously believed.
Like most things, ethical considerations for clinical trials can produce both positive and negative results. The positives, of course, include protecting the rights, safety, and well-being of trial participants. And the negatives? Aside from the financial costs associated with review (which can be substantial), current systems to ‘promote’ ethical considerations are often overly complicated and slow.