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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 this end, CGD has convened a working group to help shape the VFM agenda for global health funding agencies, with a particular focus on the Global Fund to Fight AIDS, Tuberculosis and Malaria. Leading these efforts is my guest this week, Amanda Glassman, a senior fellow and director of the global health policy program at the Center for Global Development.

Given a small budget, would it make sense to vaccinate 10 children against childhood diseases, or one woman to prevent transmission of HIV to her unborn child? In today’s global health arena where resources are limited and demands are growing, policy makers constantly face such budgetary dilemmas with little expert guidance. 

My guest on this week’s Wonkcast is Amanda Glassman –a research fellow and director of CGD’s global health program. Her recent report, Priority Setting in Health: Building Institutions for Smarter Public Spending, draws on the expertise of a CGD working group to offer recommendations for improving the allocation of scarce health funding, despite political and bureaucratic constraints.

Global health funders have historically focused their aid on countries with the lowest per capita incomes, on the assumption that that’s where most of world’s poor people live.  In recent years, however, many large developing countries achieved rapid growth, lifting them into the ranks of the so-called middle-income countries, or MICs, even though they are still home to hundreds of millions of very poor people.  Andy Sumner has called the poor people in the MICs a “new bottom billion”, as distinct from the bottom billion in poor and fragile states that Paul Collier wrote about in a popular 2007 book.

In this week’s Wonkcast, I ask Amanda Glassman, a CGD research fellow and director of our global health policy program, how global health funders should respond to the emergence of the new bottom billion. Should money that now goes to the world’s poorest countries be reallocated to reach poor people who happen to live in the new MICs? Are there other ways that the global community can help? Amanda’s answers draw on the findings of a new working paper she wrote jointly with Sumner and Denizhan Duran, and an accompanying policy brief. 

My guest on this show is Amanda Glassman, research fellow and director of CGD’s Global Health Program. I recorded this Wonkcast with her last week, just ahead of the first pledging session for the Global Alliance for Vaccines and Immunizations (GAVI). 

GAVI is a coalition of private foundations and donor country governments who work to increase the availability of vaccines, a highly cost-effective health intervention that is chronically under provided. Among other mechanisms, GAVI buys the vaccines at discount by purchasing in bulk, then passes the savings onto poor countries and expanding coverage. Over the past 10 years, GAVI estimates it has saved 5 million children from vaccine vaccine-preventable diseases, an accomplishment which Amanda considers to be remarkable.

CGD is pleased to host Sir Andrew Dillon, chief executive of the UK National Institute for Health and Clinical Excellence (NICE), and Dr. Kalipso Chalkidou, Director of NICE International, to discuss the relevance of institutions such as NICE to improving value for money in health and the characteristics, strengths and limitations of current institutions in the developed and developing world.