New Initiative to Support Priority Setting for Universal Health Coverage

<p><em>This is a joint post with <a href="/staff/kate-mcqueston">Kate McQueston</a> and <a href="/staff/jenny-ottenhoff">Jenny Ottenhoff.</a>&nbsp;</em></p><p>Universal health coverage (UHC) is now firmly on the global health agenda, and carries with it the ambitious goal of providing &ldquo;access to key promotive, preventive, curative and rehabilitative health interventions for all at an affordable cost.&rdquo;&nbsp; So where do we start?&nbsp; A critical first step to delivering on the aspirations of UHC is deciding which services and policies to prioritize and make available.&nbsp; While resources for health care are growing, they are not infinite and hard choices must be made.&nbsp;&nbsp;</p><div class="callout right"><p><strong>More on the iDSI:</strong><br />Listen to the <a href="/blog/nice-idea-priority-setting-global-health-amanda-glassman">Wonkcast</a>.<br />Read the <a href="http://www.nice.org.uk/aboutnice/niceinternational/projects/NICEInternationalLaunchesInternationalDecisionSupportInitiative.jsp?domedia=1&mid=6CE7DA30-A6B5-84C9-1DE461CFD6A74C28">strategic overview</a>.</p><p><strong>More on Priority Setting from CGD:</strong><br /><a href="/publication/priority-setting-health-building-institutions-smarter-public-spending">Full report</a><br /><a href="/publication/priority-setting-health-building-institutions-smarter-public-spending-cgd-brief">Brief</a></p></div></div><p>Priority-setting processes for health spending specify at least a certain set of policies, services and technologies that will be financed and made available under UHC.&nbsp; Some will also indicate which services or technologies will <em>not</em> be funded and provided.&nbsp; Ideally, the design of a priority setting process is fair, transparent, inclusive and deliberative.&nbsp; And in the best cases, the selection of these services is based on cost-effectiveness and accounts for equity, financial protection and social values in a systematic way.&nbsp;</p><p>When priority-setting processes aren&rsquo;t in place &ndash; that is, when resource allocation decisions are made based on past budgets or under pressure from interest group &ndash; less health is provided for every dollar spent. Evidence of suboptimal allocation abounds; India subsidizes open heart surgery while child vaccination rates remain low; Colombia purchases more analogous insulins per diabetic than any country in Latin America while diabetes prevention and management programs remain underfunded; and Egypt spent a fifth of its public spending on health to send a few fortunate people overseas for health treatments while a fifth of their children were stunted. &nbsp;(for more examples, see our report on priority-setting institutions <a href="/publication/priority-setting-health-building-institutions-smarter-public-spending">here</a>)</p><p>Under UHC, it will ultimately be up to countries to set their own priorities for health spending.&nbsp; And that&rsquo;s great - reallocating a portion of public and donor monies toward the most cost-effective health interventions would save more lives and promote health equity. But too many low- and middle-income countries lack the fair and evidence-based processes and institutions needed to adequately inform funding decisions.</p><p>With that in mind, the Center for Global Development ran a working group on priority-setting institutions during 2011/12, recommending the creation and development of national and global systems to more rationally set priorities for public spending on health. The group called for an interim secretariat to incubate a global facility designed to help governments develop national systems and donors get greater value for money in their grants.</p><p>So we&rsquo;re delighted to announce a new platform that does just that -- the <a href="http://www.nice.org.uk/aboutnice/niceinternational/projects/NICEInternationalLaunchesInternationalDecisionSupportInitiative.jsp?domedia=1&amp;mid=6CE7DA30-A6B5-84C9-1DE461CFD6A74C28" target="_blank">international Decision Support Initiative</a> (iDSI).&nbsp; Recently launched by <a href="http://www.nice.org.uk/aboutnice/niceinternational/niceinternational.jsp" target="_blank">NICE International</a>, the iDSI will support low and middle income governments, and perhaps donors, in making resource allocation decisions for healthcare. &nbsp;Specifically, the initiative will share experiences, showcase lessons learned and identify practical ways to scale technical support for more systematic, fair and evidence informed priority setting processes.&nbsp;In strengthening priority-setting institutions, the iDSI will be a tool to both improve access to effective health interventions and the quality and efficiency of health care delivery. And importantly, it will help elevate the value of priority setting as a necessary, if not sufficient, condition for attaining and sustaining UHC.&nbsp;</p><p>The full announcement from NICE International on the iDSI can be found <a href="http://www.nice.org.uk/aboutnice/niceinternational/projects/NICEInternationalLaunchesInternationalDecisionSupportInitiative.jsp" target="_blank">here</a> and the strategic overview <a href="http://www.nice.org.uk/aboutnice/niceinternational/projects/NICEInternationalLaunchesInternationalDecisionSupportInitiative.jsp?domedia=1&amp;mid=6CE7DA30-A6B5-84C9-1DE461CFD6A74C28" target="_blank">here</a>. For more information on CGD&rsquo;s work on Priority-Setting, see the report&rsquo;s brief <a href="/publication/priority-setting-health-building-institutions-smarter-public-spending-cgd-brief" target="_blank">here</a> and a wonkcast on the topic, <a href="/blog/priority-setting-health-building-institutions-smarter-public-spending-%E2%80%94-amanda-glassman" target="_blank">here</a>. &nbsp;</p>