As governments across the world expand population access to health care, they are feeling the pressure of rising costs. According to the IMF, emerging economies will spend an additional 1.5 percentage points of GDP on health care over the next 20 years, most of which will come from excess cost growth – defined as health care cost growth related to new medical technologies and income growth, rather than aging.
While smoking is on the decline in Europe, the US, and other parts of the developed world, low- and middle-income countries are facing opposite trends in consumption. Currently 80% of all deaths attributable to tobacco occur in low- and middle income countries. Asia in particular faces high prevalence rates of tobacco use—the Western Pacific region accounts for 48% of world cigarette consumption. Part of the significant consumption can be attributed to the increasing affordability of tobacco products. Between 2000 and 2010 the relative income price of cigarettes decreased by 34% in South-East Asia and 18% in the West Pacific. See the fourth edition of the World Tobacco Atlas (2012) for more information.
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.
This week the Global Fund Board will determine whether to “expand, accelerate, terminate or suspend the Affordable Medicines Facility – malaria (AMFm).” Ideally, the Board would make an evidence-based decision. However, both the sufficiency and the relevance of available technical evidence have been questioned (see here and here). The role of political and process evidence is also not very transparent. Below, we lay out our understanding of the potential options and the factors the Board should consider.
There was bad news in research published yesterday in the New England Journal of Medicine about the effectiveness of what had seemed to be the best prospect for a malaria vaccine, known by the unsexy name of 'RTS,S'.
The study of the phase III trials finds that in babies (aged 6-12 weeks) the vaccine only reduces malaria by less than a third. This is disappointing because this is less than half the effectiveness that had been suggested by the phase II clinical trials.
This is a joint post with Heather Lanthorn.
The Global Fund Board’s decision over the Affordable Medicines Facility – malaria (AMFm) rapidly approaches, and tensions within the malaria community are acute. In her global health blog for The Guardian, Sarah Boseley characterizes the rift as one of
“huge arguments and intense passions…[because] it is about the belief on one side that the private sector is the most effective way to get medicines to those who need them – and the certainty on the other side that bolstering the public sector to diagnose and treat people is a fairer and safer way to go. These are not just practical matters, but highly political.”
Happy November 7! The election is over and…things pretty much look the same way they did before. While I don’t expect the political gridlock in Washington to abate much over the next years, global health fortunately remains one of the few areas of bipartisan consensus in US policy. When dollar values are taken out of the equation, most policy makers can agree that saving lives of mothers, children and families from preventable, treatable diseases reflects American values and contributes to a safer, healthier world. Here are five things that should be at the top of the President’s global health agenda for the next four years.
This is a joint post with Kate McQueston.
"Every country, no matter how wealthy or how impoverished, cannot afford to waste money in healthcare on health technology that does not contribute to health."
These words were spoken by Harvey V. Fineberg, the President of the Institute of Medicine, at a recent event co-hosted by CGD and PAHO, which highlighted the importance of supporting health technology assessment (HTA) in the Americas. Low-and middle-income countries are increasingly interested in building capacity for priority setting, particularly in regards to public funding in a time where pressures to incorporate costly new technologies are on the rise and donor contributions are stagnating. Over the past five years Brazil, Chile, Costa Rica, Colombia, Croatia, Estonia, the Republic of Korea, Malaysia, and Uruguay have also added health technology assessment agencies—tasked with varying responsibilities, including the generation or coordination of health technology assessment and budget impact analysis, as well as the creation recommendations for coverage or reimbursement decisions related to public spending.
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.
When the Global Fund to Fight AIDS, Tuberculosis and Malaria was created in 2002, it was intended to combat the global burden of these diseases while simultaneously delivering aid in new, innovative ways. In 2012, an increasingly austere budget climate has added pressure for the Global Fund to explore new approaches to global health financing and generate better “value for money"—a top concern to global health donors, who want the biggest bang for their buck in terms of lives saved and epidemiological progress.