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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).
I am pleased to announce that Amanda Glassman joins CGD today as the new director of CGD’s Global Health Policy program and a CGD research fellow. Amanda was chosen from a crowded field of highly qualified candidates, and I am delighted to welcome her to CGD.
Ruth also initiated and led a working group on Advance Market Commitments for vaccines, which led to a $1.5 billion pilot program for a vaccine to prevent pneumococcal disease in developing countries, where three million children die annually of diseases caused by the bacterium.
Perhaps as importantly, Ruth established the CGD working group model, which we have since applied to more than a dozen initiatives, several of which have achieved significant and lasting impacts to improve the lives of poor people in the developing world.
So, as you can see, Amanda has big shoes to fill! Fortunately, she is superbly prepared to not only continue Ruth’s work but to take it to the next level.
Amanda has worked for 15 years on health and social protection policy in the developing world, with particular attention to Latin America. She comes to us from the Inter-American Development Bank where she was the principal technical lead on health and designed, supervised and evaluated health and social protection programs. Before that she was deputy director for the Global Health Financing Initiative at Brookings, where she did policy research on aid effectiveness and domestic financing of health in low-income countries. She holds a master’s degree from the Harvard School of Public Health; has published articles on poverty, health insurance and social protection; and is coauthor of From Few to Many: A Decade of Health Insurance Expansion in Colombia and The Health of Women in Latin America and the Caribbean.
Besides these technical qualifications, Amanda has first-hand knowledge of the CGD working group approach, having served as a member of the Performance Based Incentives working group, one of several that Ruth initiated and chaired. As importantly, she brings an openness to new ideas and collaborative learning that fit well with CGD’s approach to generating ideas and moving them into action—an approach that Ruth helped to pioneer, and which has since become such a crucial part of our DNA.
Welcome, Amanda! And to our readers: watch this space!
With dismay, I read today this piece in The Economist - which adds their important voice to the chorus calling for bednet programs based on universal
free giveaways. The Economist bases its endorsement on a recent study by the WHO assessing malaria interventions in four countries which purportedly overturns the prevailing wisdom.
First, the prevailing wisdom.
Two reviews, one by Roll Back Malaria, and another by the World Health Organization's malaria department, have been conducted on how to achieve high and sustained coverage of bednets. Both concluded the same thing: to achieve and sustain bednet coverage, multiple distribution strategies involving both public and private sector distribution are more effective than public distribution
alone. And, pregnant women and children should pay low or no price - while others continue to pay positive prices.
The logic of free bednets, and public sector distribution is obviously seductive...and now it
can count The Economist among its conquests. So, perhaps it is worth reiterating why these reviews concluded there is a need for positive prices and private distribution and sale of bednets.
Why positive prices:
The effect of bednet coverage interventions relies crucially on the supply response. It is critical that suppliers be motivated to sell nets - and both public and private suppliers are more responsive when prices are positive. My colleague Mead Over recently blogged about how positive prices engender supply responses in public facilities.
Payment for bednets frees up program funding for other uses. African governments' budgets for health are extremely limited; and donor resources are insufficient to cover the cost of the "big three" malaria interventions (bednets, treatment, and spraying). Other malaria program interventions, such as stimulating demand and use of nets, and improving case management of malaria are very effective; some scarce program dollars need to be allocated here rather than widening price subsidies. For example, despite widespread support, the Affordable Medicine Facility to fund malaria drugs is not yet funded.
Why public and private distribution is needed:
Private distribution and supply is less susceptible to breakdown related to the volatility of donor funding (Amanda Glassman and Christopher Lane recently drew much-needed attention to the destructive impact on program effectiveness linked to volatility of aid flows)
Private distribution and supply is less susceptible to breakdown related to public sector management problems (Richard Tren and colleagues at Africa Fighting Malaria describe here a three year freeze in
public sector distribution of bednets in Uganda due to problems between the Ugandan government and the Global Fund)
Private distribution and sale is available outside the time parameters of public sector campaign - which is critical to ensure coverage of newly pregnant women and newly born children.
Private sellers increase use by sensing and responding to consumer preferences (people like different colored, different shaped nets and will buy more if they have product choice)
Private distribution chains are often more effective than public sector in getting products out to rural and hard-to-reach areas
As new studies are done, they most assuredly should be considered together with all the other evidence,
to see if the balance has shifted enough to justify altering the guidelines. As noted in The Economist, the interventions assessed included simultaneous free distribution of bednets and free distribution of artemisinin drugs - the highly-effective malaria treatment. So these reviews do not shed light on the relative effectiveness of bednet coverage interventions.
While the review canâ€™t shed light on bednet coverage interventions, the very high mortality reductions
in Ethiopia, Rwanda and Zambia from the dual (bednet/ drug) intervention are striking. These findings should be examined as quickly as possible to inform malaria programs being designed now.
Unfortunately, the WHO review mentioned in The Economist is not published or available for review
- so it is not possible to judge the quality of the analysis. Nor do we know how to interpret the findings. Mr. Kochi, who is quoted in the article, has demonstrated a tendency to "get ahead of the facts" on this very topic in the not-too-distant past (subscription required). Malaria program funders are urged to be a bit more cautious than The Economist in interpreting the findings pending their review.
Conditional Cash Transfer (CCT) programs are one way to create incentives for poor people to use preventive healthcare services. Evaluations show that CCT programs work, and their use is spreading rapidly throughout the developing world. This paper analyzes key features of CCT programs and offers practical advice for their future design.
Evidence shows that when women have the opportunity to serve as political leaders, governments are not only more inclusive but also perform better. Women politicians are shown to champion policies improving health services and education systems, and they serve as positive role models influencing girls’ career aspirations and educational attainment. But across the world, women’s rates of political leadership remain lower than men’s. What are the obstacles standing in the way of women’s equal political participation? And what can be done to overcome these obstacles?
No one really understands why the first letter is lower case and the rest are in capitals. But one thing that is clear to anyone who has heard of iDSI is that it fills a growing gap in how developing countries decide how to allocate their strained health budgets. The International Decision Support Initiative is a network of expert organizations that helps policymakers make effective, efficient, and ethical decisions about how to prioritize limited resources.
Over the past 15 years, people in low- and middle-income countries have experienced a health revolution—one that has created new opportunities and brought new challenges. It is a revolution that keeps mothers and babies alive, helps children grow, and enables adults to thrive. Millions Saved, authored by Amanda Glassman and Miriam Temin with the Millions Saved team, chronicles this global health revolution from the ground up. It showcases 18 remarkable cases in which large-scale efforts to improve health in developing countries succeeded and 4 cases in which promising interventions fell short of their health targets when scaled-up. Each case demonstrates how much effort is required to fight illness and sustain good health.
There is a lot of development data out there. But how do we translate this information into better development decisions--and better outcomes? This event, convened by the development nonprofit TechnoServe, in collaboration with the Center for Global Development, will explore some of the key questions that affect billions of aid dollars: How do we compare cost-effectiveness across a wide spectrum of projects? What would development look like if long-term impact studies were a part of every project design? How do we leverage rigorous findings of impact to scale successful projects?