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evidence-informed policy, health technology assessment, priority-setting, universal health coverage
Kalipso Chalkidou is the Director of Global Health Policy and a Senior Fellow at the Center for Global Development. Previously, she was the Director of Global Health and Development Group at the Institute of Global Health Innovation, Imperial College London, helping governments build technical and institutional capacity for improving the value for money of their healthcare investment. She is interested in how local information, local expertise, and local institutions can drive scientific and legitimate healthcare resource allocation decisions whilst improving patient outcomes.
She has been involved in the Chinese rural health reform and also in national health reform projects in the USA, India, Colombia, Turkey and the Middle East, working with the World Bank, PAHO, DFID and the Inter-American Development Bank as well as national governments. Between 2008 and 2016 she founded and ran NICE International, a non-profit group within the UK’s National Institute for Health and Care Excellence (NICE).
Culyer, Anthony J., and Kalipso Chalkidou. "Economic Evaluation for Health Investments En Route to Universal Health Coverage: Cost-Benefit Analysis or Cost-Effectiveness Analysis?" Value in Health, July 2018. (Open Access)
Five years after the landmark UN endorsement, countries around the world are now working to translate the lofty rhetoric of UHC into defined, tangible, equitable, and comprehensive health services for their populations. On December 12th, the world will officially mark the 5th annual Universal Health Coverage (UHC) Day—an opportunity to reflect on the global community’s role in supporting progress toward this important goals. In celebration of UHC day, the Center for Global Development is pleased to host a short program—Better Decisions, Better Health: Practical Experiences Supporting UHC from around the World—featuring practical experiences supporting UHC from Southeast Asia, Sub-Saharan Africa, and at the global level. A keynote address from Mark McClellan will precede remarks and presentations from the core partners of the International Decision Support Initiative (iDSI).
Whether it’s called strategic purchasing, evidence-informed commissioning, or value-based insurance, the quest to squeeze better value out of existing resources is global. But lack of clarity regarding global and national healthcare investment goals, coupled with low technical capacity in ministries of health and insurance funds and multiple competing interests for attracting healthcare dollars, all make proactive evidence-informed buying hard to achieve. The global health community ought to help Ghana and countries like it strengthen their national systems for allocating resources including when selecting, negotiating prices, and procuring medicines for their populations.
With aid budgets shrinking and even low-income countries increasingly faced with cofinancing requirements, this is the right time for global health funders such as the Global Fund and their donors to formally introduce Health Technology Assessment (HTA), both at the central operations level and at the national or regional level in recipient countries. In this CGD Note, we explain why introducing HTA is a good idea. Specifically, we outline six benefits that the application of HTA could bring to the Global Fund, the countries it supports, and the broader global health community.
In April this year, the National Academies of Science, Engineering, and Medicine (NASEM) published a report making the case for “Integrating Clinical Research into Epidemic Response.” As reflected in its title, the 250-page-plus-appendices report makes a strong evidence-informed argument for integrating health service delivery with clinical research conducted during epidemics. The goal is to produce critical information on the efficacy and safety of potential therapeutics and vaccines for tackling such epidemics after they occur, or, better still, for preventing them from happening. Earlier this week, the group reconvened at the Wellcome Trust to discuss “what next.” The need to focus on systematic support and funding for the data collection and research functions in outbreak-affected countries came out again as the top priority.
Vaccinate children against measles and mumps or pay for the costs of dialysis treatment for kidney disease patients? Pay for cardiac patients to undergo lifesaving surgery, or channel money toward efforts to prevent cardiovascular disease in the first place? For universal health care (UHC) to become a reality, policymakers looking to make their money go as far as possible must make tough life-or-death choices like these.
Many low- and middle-income countries aspire to universal health coverage (UHC), but for rhetoric to become reality, the health services offered must be consistent with the funds available, which may require tough tradeoffs. An explicit health benefits package—a defined list of services that are and are not subsidized—is essential in creating a sustainable UHC system.
A new contribution from the Center for Global Development and the International Decision Support Initiative (iDSI)—What’s In, What’s Out: Designing Benefits for Universal Health Coverage, edited by Amanda Glassman, Ursula Giedion and Peter Smith—argues that an explicit health benefits package (HBP), to be funded with public monies, is an essential element of a sustainable and effective health system, and considers the institutional, fiscal, methodological, legal, and ethical dimensions of their design and implementation. This event—a private policy breakfast and release of the book—aims to gather leading voices for universal health coverage, effective health financing, and evidence-based health policy to discuss and debate the book’s key findings and messages. Hard copies of the book will be available for all attendees.
Global Burden of Disease (GBD) country rankings can strengthen the case of advocates at global and national levels for prioritising investment towards the major drivers of mortality and morbidity. But as discussed in our earlier blog post, when it comes to informing specific investment cases within these broader priorities, GBD data alone are not enough to allow consideration of trade-offs and of opportunity costs of alternative investment choices addressing the same problem. The next step in using data to trigger action ought to be the generation, in conjunction with domestic stakeholders, of what we call below “super-local data.”