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Health financing and payment, results-based financing, social protection, conditional cash transfer programs, noncommunicable disease, maternal and child health
Amanda Glassman is chief operating officer and senior fellow at the Center for Global Development and also serves as secretary of the board. Her research focuses on priority-setting, resource allocation and value for money in global health, as well as data for development. Prior to her current position, she served as director for global health policy at the Center from 2010 to 2016, and has more than 25 years of experience working on health and social protection policy and programs in Latin America and elsewhere in the developing world.
Prior to joining CGD, Glassman was principal technical lead for health at the Inter-American Development Bank, where she led policy dialogue with member countries, designed the results-based grant program Salud Mesoamerica 2015 and served as team leader for conditional cash transfer programs such as Mexico’s Oportunidades and Colombia’s Familias en Accion. From 2005-2007, Glassman was deputy director of the Global Health Financing Initiative at Brookings and carried out policy research on aid effectiveness and domestic financing issues in the health sector in low-income countries. Before joining the Brookings Institution, Glassman designed, supervised and evaluated health and social protection loans at the Inter-American Development Bank and worked as a Population Reference Bureau Fellow at the US Agency for International Development. Glassman holds a MSc from the Harvard School of Public Health and a BA from Brown University, has published on a wide range of health and social protection finance and policy topics, and is editor and coauthor of the books Millions Saved: New Cases of Proven Success in Global Health (Center for Global Development 2016), From Few to Many: A Decade of Health Insurance Expansion in Colombia (IDB and Brookings 2010), and The Health of Women in Latin America and the Caribbean (World Bank 2001).
The Working Group on Clinical Trials and Regulatory Pathways
This report of the Working Group on Clinical Trials and Regulatory Pathways provides practical policy recommendations to help provide better, safer, and cheaper medicine and treatment to the 1 billion people suffering from neglected diseases.
After a decade of rapid growth in average incomes, many countries have attained middle-income country (MIC) status, while poverty hasn’t fallen as much as one might expect. As a result, there are up to a billion poor people or a ‘new bottom billion’ living not in the world’s poorest countries but in MIC. Not only has the global distribution of poverty shifted to MIC, so has the global disease burden. The paper describes trends in the global distribution of poverty, preventable infectious diseases, and health aid response to date and proposes a new MIC strategy and components, concluding with recommendations.
News this month that an experimental vaccine cuts in half the risk of malaria in children in Africa is a welcome success story 20+ years in the making. It’s also a rare bright spot in the clinical trials labyrinth that stands between promising new medicines, vaccines, and diagnostic techniques and the one billion people in the developing world who suffer from one or more neglected diseases. Ninety other drug and vaccine candidates for neglected diseases are waiting in the pipeline for late stage clinical development. Under current arrangements, they will face lengthy, inefficient reviews in countries where the regulatory capacity ranges from weak to non-existent.
Update (December 6): This week, members of the health community are gathering at the third annual mHealth Summit in Washington, D.C., to explore ways to advance mobile technologies for health. The summit will focus on the business and policy perspectives of mHealth, aiming to identify sustainable business models to support mHealth around the globe. Below, Amanda Glassman and Vicky Hausman highlight key actions major global health donors should take to help realize the potential of mHealth and move to scalable and sustainable integration of mobile into healthcare delivery.
This blog is co-authored with Vicky Hausman, Dalberg Global Development Advisors.
These days it seems like everyone is going mobile. The idea of using mobile phones to deliver health care products, treatments and services has captured the imaginations of everyone from academic experts, government officials and funders of aid to technology companies, innovators and entrepreneurs. There is no shortage of conferences, webinars or tweets on the topic, nor is there a lack of innovative applications and technology.
But what is the reality? Has mHealth really begun to transform health systems?
Safer, Faster, Cheaper: Improving Clinical Trials and Regulatory Pathways to Fight Neglected Diseases
Keynote AddressMargaret A. HamburgCommissioner of the U.S. Food and Drug Administration
Presentation of the Working Group’s Key RecommendationsThomas BollykyFormer CGD Research Fellow and Working Group Chair
Panel Discussion FeaturingMichael Brennan
AERAS Global TB Vaccine Foundation
Johns Hopkins Bloomberg School of Public Health
Bill & Melinda Gates FoundationModerated byAmanda Glassman
Director of Global Health Policy & Research Fellow
Center for Global Development
Monday, October 31, 2011
4:00pm – 5:30pm
*Reception to follow*
at Center for Global Development
1800 Massachusetts Avenue, NW, First Floor Washington, DC
*Please bring photo identification*
An estimated one billion people suffer from one or more neglected diseases like Tuberculosis, Malaria, Dengue Fever or others, and hundreds of millions of dollars have been spent to find effective treatments. Medicines, therapies and treatments have been discovered, but regulatory barriers in the late-stage clinical trials of developing countries have prevented these drugs from helping those in need.
The report of the Center for Global Development Clinical Trials and Regulatory Pathways Working Group —chaired by Tom Bollyky—offers practical and scalable policy recommendations to expedite the clinical trials process in developing countries. The report suggests a two pronged solution: (1) the development of regional pathways for the review of clinical trials in disease-endemic settings, and also (2) better, faster, and cheaper clinical trials by focusing on key parameters and objectives of trials, evidence-driven approaches, and early engagement among trial sponsors.
FDA Commissioner Margaret A. Hamburg’s opening remarks will be followed by presentation of the key findings and a discussion panel featuring members of the Clinical Trials and Regulatory Pathways Working Group.
Everyone seems to be throwing their hat into the ring in the battle against non-communicable disease (NCD), from George W. Bush to Lance Armstrong. Now it appears USAID has entered the mix as well. Despite the agency’s absence from a CGD sponsored panel discussion last week, the USAID communications department is shifting into full gear—implying that they plan to join the fight after all.
Two months ago, we set out to create an index that measures the quality of health aid. Here’s why: First, with the approaching 4th High Level Forum on Aid Effectiveness in Busan, aid quality is becoming an important topic of discussion. The recently released results of the Paris Declaration survey (discussed here) show that donors failed to reach almost all of the targets they specified themselves. In this context, mutual accountability between donors and partners is becoming more important, and such an index can help foster accountability. Second, we felt that looking at aid effectiveness at a micro level gave a better sense of the challenges that are faced on the macro level – and health is one of the largest and most complex aid sectors. Third, while there are initiatives and case studies on aid effectiveness in health, including IHP+ Results, there is a lack of quantitative analysis: OECD has declared health to be a tracer sector and published a report, which mostly relies on qualitative case studies. Finally, the Center for Global Development already has a methodology for evaluating aid effectiveness, called the Quality of Official Development Aid (QuODA), which will soon be updated – why not adapt it for the health sector?
The latest effort to address aid coordination problems and health system issues – the Health System Funding Platform (the Platform) – is evolving slowly and beginning to recreate the same traps it was supposed to solve. In a paper released this month, Bill Savedoff and I show how the natural tendency for aid agencies to fall back on measuring and paying for inputs is likely to undermine the Platform’s goals. Linking funding to results is the most promising way for the donors to achieve the aims they initially set for the initiative.
As the GAVI Alliance gears up for its pledging conference in June, a CGD panel reflected on progress and lessons learned in financing GAVI since 2001 and explored implications for the next decade. Speakers had first-hand experience in the design and implementation of the major vaccine financing instruments—Alice Albright, former CFO of GAVI; Michael Kremer, co-chair of CGD’s Advance Market Commitment (AMC) Working Group; Helen Evans and David Ferreira, GAVI; and Amie Batson, Deputy Assistant Administrator for Global Health at USAID. Key takeaways from the event are directly below, and a longer summary—with embedded video clips—is below that. You can also watch a full recording of the event here.
Why is the World Health Organization (WHO) facing a financial crisis at a time when international support for global health issues has never been higher? The answer to this question cannot be found in any of the documents circulated for the 2011 World Health Assembly this week, but most observers cite three contributing factors: donors question the WHO’s performance, new organizations dedicated to specific issues have assumed responsibility for large parts of the global health agenda, and the WHO lacks a vision for its role and specific priorities within this new multi-faceted global health community.