Priority Setting Institutions for Health

Health policymakers, practitioners and funders continuously make life-and-death decisions about which type of patients receive what interventions, when, and at what cost. These decisions--as consequential as they are--often result from ad hoc, nontransparent processes driven more by inertia and interest groups than by science, ethics, and the public interest. The result is perverse priorities, wasted money, and needless death and illness. The Priority-Setting Institutions for Global Health working group first met over a year ago, tasked with identifying the characteristics of processes and institutions that are capable of transparently and ethically translating scientific and economic evidence and social preferences on health technologies into on-budget priorities in low- and middle-income settings. This month we were pleased to launch this group’s final report in London, at a reception at the House of Lords. We have a full set of materials, including the full report, brief, press release, and Amanda Glassman’s wonkcast discussing the report. We will hold a US-based launch later this year.

CGD and the AIDS 2012 Conference

On July 22-27th , Washington will be hosting the International Aids Conference. This year’s IAEN AIDS and Economics Pre-Conference will be held at CGD during a 2-day invite-only symposium on July 20-21, 2012, with introductory remarks by Ambassador Eric Goosby. The purpose of the seminar is to foster better research on the economics of HIV, and as such, the conference brings together policymakers and researchers from around the globe to present and discuss the most recent developments in the field of HIV and economics. CGD will also be holding a satellite session entitled, Using Global Payers to Improve Efficiency in Prevention and Treatment of HIV/AIDS, as part of the International Aids Conference itself and relating to CGD’s work in Value for Money for Global Health Funders. More details on this panel are forthcoming. Other events are also in their planning stages--make sure to check out our events page and blog for updates and more information.

State Health Insurance and Out-of-Pocket Health Expenditures in India

When an individual falls sick and incurs ‘out-of-pocket’ expenses for health care, the impacts on household finances can be severe. Insurance reduces the price of treatment faced by a household, and hence may lower the burden of out-of-pocket health costs for household and the risk of impoverishment associated with illness. On the other hand, access to insurance coverage may increase utilization of health-care and under some circumstances have the opposite effect (overall higher costs) on out-of pocket health expenditures. In 2007, the state of Andhra Pradesh in southern India began rolling out the Aarogyasri health insurance to reduce catastrophic health expenditures in households below the poverty line. In a new CGD working paper titled State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India, Victoria Fan, Anup Karan, and Ajay Mahal analyize the effect of this program, finding that within the first year of implementation, Phase I of Aarogyasri significantly reduced out-of-pocket inpatient expenditures and, to a lesser extent, outpatient expenditures. None the less, the authors find no clear effects on catastrophic health expenditures or medical impoverishment.

Gains in Afghan Health

This month CGD welcomed Kenneth Hill, Professor of Global Health and Population and Harvard University, at a seminar examining the results of the 2010 Afghanistan Mortality Survey. These findings were hailed as showing dramatic declines in child and maternal mortality when they first became available last year. However, more detailed examination of the results has raised questions about their accuracy. Hill’s presenation can be found here, as well as a response by discussants Pav Govindasamy (ICF Macro) and Mohammad Hafiz Rasooly (Ministry of Public Health, Afghanistan) here. Victoria Fan and Kate McQueston blog about these findings in a post entitled, “Stunning Progress” or “Implausible and Invalid”: the Afghanistan Mortality Survey 2010?.