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Global Health and social policy; proven successes in global health, incentives for vaccine R&D, evaluation
Ruth Levine was a senior fellow at the Center for Global Development from the fall of 2001 until March 2010. Already an internationally recognized health economist, she joined as a senior fellow and later became CGD’s vice president for programs and operations. One of CGD’s early core experts, Levine helped to shape the Center’s unique approach to making the world a better place and created and fine-tuned CGD’s model for working groups, chairing several that addressed the effective use of donor funding for health programs in low-income countries.
“3ie has made my job much easier.” This is what we heard last month from a high-ranking government official in Africa, referring to the International Initiative for Impact Evaluation (3ie), and it made us very proud. Creating 3ie was the outcome of the Evaluation Gap Working Group that we led along with Nancy Birdsall to address the limited number of rigorous impact evaluation of public policies in developing countries. As CGD celebrates its 15th year, it is worth considering what made that working group so successful, the obstacles we confronted, and the work that still remains to be done.
Chris Elias, President & CEO at PATH, will step down from his current position and join the Bill & Melinda Gates Foundation (BMGF) as President for global DEVELOPMENT in February 2012. Yes, that’s global development, not global health. First reactions from many in global health lamented the "loss" of one of the field’s most accomplished and visible experts. But as we digested the details of the announcement and discussed its implications, we realized that the Foundation’s decision could be a bonanza for global health. Here are two reasons why:
Each year billions of dollars are spent on thousands of programs to improve health, education and other social sector outcomes in the developing world. But very few programs benefit from studies that could determine whether or not they actually made a difference. This absence of evidence is an urgent problem: it not only wastes money but denies poor people crucial support to improve their lives.
The wellbeing of adolescent girls in developing countries shapes global economic and social prosperity -- yet girls' needs often are consigned to the margins of development policies and programs. This new report describes why and how to provide adolescent girls in developing countries a full and equal chance in life. Offering targeted recommendations for national and local governments, donor agencies, civil society, and the private sector, Girls Count provides a compelling starting point for country-specific agendas to recognize and foster girls' potential.
In a pathbreaking follow-up to the 2008 report Girls Count, Miriam Temin and CGD vice president Ruth Levine shed light on the reality of girls’ health worldwide and its enormous on the wellbeing and productivity of girls, their families, and their nations. Start with a Girl: A New Agenda for Global Health highlights successful efforts to break the cycle of ill health and proposes a comprehensive, practical health agenda that starts with adolescent girls.
Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group
Donor spending on global health has surged, yet for many poor people in developing countries even basic prevention and treatment remain elusive. CGD’s newest book, Performance Incentives for Global Health: Potential and Pitfalls, shows how modest payments in cash or kind can get more health from health care spending. Informed by case studies and the Working Group on Performance-Based Incentives, co-authors Rena Eichler and CGD vice president Ruth Levine tell how to design and implement effective incentive programs—and what to avoid.
Millions Saved: Proven Success in Global Health details 17 cases in which large-scale efforts to improve health in developing countries have succeeded, saving millions of lives and preserving the livelihoods and social fabric of entire communities.
This paper analyzes the use of incentives (money, food and other material goods) for patients and healthcare providers to improve tuberculosis detection and treatment. It finds that although managing the distribution of money and food can be complicated, performance-based incentives do work. It ends with suggestions for improving future programs.
USAID launched a project in 1995 to deliver basic health services in Haiti. The project began by reimbursing NGOs for their expenditures, but evolved to include payments based partly on performance targets. The result: marked improvements in health, particularly in immunization coverage and attended deliveries.
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.
Nicaragua was one of the first low-income countries to try a conditional cash transfer (CCT) program. Under the program, poor families are paid for keeping their children in school and visiting preventive healthcare providers. Healthcare providers are paid based on their performance against predetermined targets. A rigorous evaluation of the program shows that the CCT program significantly increased the use of health services among the poor.
Donors are considering committing in advance to purchase vaccines against diseases concentrated in low-income countries to spur research and development on vaccines for neglected diseases. How much money is needed? The authors of this paper find that a commitment comparable in size to the average sales of recently launched commercial products (adjusted for lower marketing costs)—about $3 billion per disease when products are at a relatively early stage in development —would be a highly cost-effective way to address major killers, such as malaria, tuberculosis and HIV/AIDS. The paper includes a link to a Web-based spread sheet for readers to conduct their own sensitivity analysis.Learn more