With rigorous economic research and practical policy solutions, we focus on the issues and institutions that are critical to global development. Explore our core themes and topics to learn more about our work.
In timely and incisive analysis, our experts parse the latest development news and devise practical solutions to new and emerging challenges. Our events convene the top thinkers and doers in global development.
Health financing, social protection, maternal and child health, aid effectiveness, impact evaluation
Victoria Fan is an assistant professor at the University of Hawaii at Manoa and non-resident fellow at the Center for Global Development. She is a health economist, focused on evaluating the effectiveness and efficiency of health policies and interventions. Fan was a research fellow (2011-14) and visiting fellow (2014-18) at the Center for Global Development. Her work in health economics and health systems has contributed to identifying the health financing transition, landscaping the health workforce in China and India, and assessing payment and incentive mechanisms. She has written papers on aid effectiveness and value for money of development assistance for health. Her work using impact evaluation and economic evaluation in health have assessed the costs and benefits of health interventions and health risks, including social policy, diabetes prevention, dental sealants, end-of-life care, and pandemic influenza. She has been invited as a guest speaker by, or given advice to, multilateral institutions (e.g. UNICEF and WHO) as well as national governments (e.g. China, India, South Korea, Thailand). She has worked with nongovernmental organizations in Asia (BRAC, SEWA, Tzu Chi) and at units at Harvard University (Harvard Initiative for Global Health, Harvard Global Equity Initiative, Harvard University Program for Health Care Financing). She previously served as a consultant for the China Medical Board, World Bank and World Health Organization and on studies supported by the Rockefeller Foundation and the Bill & Melinda Gates Foundation. She earned her doctor and master of science in global health and population from Harvard School of Public Health and bachelor of science in mechanical engineering from the Massachusetts Institute of Technology.
At the IAS conference, protestors turned out to oppose one reform under consideration at the Global Fund for AIDS, Tuberculosis, and Malaria: allocating funding ex ante instead of having countries propose the amount they would like to receive. Mohga Kamal-Yanni of Oxfam writes:
Christmas came early this year for the wonkiest of PEPFAR-watchers. Our gift: the preliminary report on the pilot of PEPFAR’s Expenditure Analysis Initiative, an important and exciting move by PEPFAR towards evidence-based decision making and greater transparency.
This month, both Health Affairs and the Journal of Acquired Immune Deficiency Syndrome (JAIDS) released special thematic issues on the US President’s Emergency Plan for AIDS Relief (PEPFAR) in which the articles – mainly commentaries but some analyses – provide an exceptionally positive readout on PEPFAR’s past performance and future direction. In principle, this is great – any insights into PEPFAR are always welcome, and it’s clearly valuable to discuss and disseminate lessons learned from the program. If these articles were posted on the PEPFAR website, or released as official PEPFAR reports, we wouldn’t bat an eye. But within scientific, peer-reviewed journals, the articles read more like PEPFAR PR rather than commentary and analysis from independent, third-party observers and stakeholders. A quick skim of the titles in the table of contents illustrates this point (see word cloud of selected title excerpts), and a closer look at the contributors sheds some light on why this may be the case: most authors of the articles are somehow affiliated with PEPFAR or with organizations that have received money from the program.
In this austere budget climate, generating “value for money” (VFM) is a top concern for global health funding agencies and their donors, who want the biggest bang for their buck in terms of lives saved and diseases controlled. To that end, CGD has convened a working group to help shape the VFM agenda with high impact recommendations for reducing costs, increasing impact per dollar spent, and focusing investments on the highest impact interventions among the most affected populations. Since our first meeting in April, we’ve been hard at work collecting evidence, consulting with global health agencies, and identifying the most promising areas for further investigation. The main funding agency under our VFM microscope: the Global Fund to Fight AIDS, Tuberculosis and Malaria.
The Center for Global Development is hosting a satellite session at the XIX International AIDS Conference entitled "Using Global Payers to Improve Efficiency in Prevention and Treatment of HIV/AIDS." This panel will evaluate institutional perspectives on policies to improve efficiency for major global health donors such as the Global Fund. Panelists will offer assessments of the sustainability of Global Fund supported AIDS treatment across a range of funding scenarios, evaluate resource needs for HIV prevention, and examine opportunities for the Global Fund to exploit available policy instruments in order to improve the “value for money” it receives in HIV/AIDS and its other diseases. The following discussion will offer comments on the relevance of these ideas for the on-going reform of the Global Fund.
A new pay-for-performance approach to spur the 35 states of India to perform better in the health sector was recently announced. For the first time, central government funding to individual states under the country's 'flagship' health program, the National Rural Health Mission (NRHM), will depend on the state's performance. According to a Times of India news article, states that fail to perform on certain areas – primarily a more equitable distribution of doctors and nurses – will have their NRHM budget reduced, while states demonstrating performance on other areas, such as providing free generic drugs at public facilities, can earn additional outlays.
This is a joint post with Heather Lanthorn, a doctoral candidate at Harvard School of Public Health.
In mid-July, amidst the busy global-health month of July, in between the Family Planning summit and the AIDS conference, the near-final draft of the independent evaluation of the Affordable Medicines Facility - Malaria (AMFm) was released.
Since October 2010, Haiti has struggled to control a deadly cholera outbreak—on top of ongoing recovery efforts from the devastating earthquake in January 2010. To date 7000 Haitians have died from cholera and more than half a million have been infected; PAHO recently called it the largest cholera outbreak in modern history. So last month, a group of lawyers in Haiti, on behalf of some 15,000 victims of cholera, sued the United Nations for $50,000 for each victim and double that for families of those who died.
As the Global Fund’s November board meeting approaches – where the future of the Affordable Medicines Facility for Malaria (AMFm) hangs in the balance – there is much anxiety that AMFm will be terminated in 2013. The reason for such anxiety is clear: no donors have pledged funding commitments for after December 2012. But there’s another elephant in the room: the US government’s apparent lack of support, particularly its legislated “opt-in” stance on AMFm: “the Global Fund should not support activities involving the ‘Affordable Medicines Facility-malaria’ or similar entities pending compelling evidence of success from pilot programs as evaluated by the Coordinator of United States Government Activities to Combat Malaria Globally.” (Conversely, an opt-out stance would be to support AMFm unless no compelling evidence is presented.) This very specific and strict provision makes the AMFm’s continued survival all but impossible without an explicit endorsement by US Global Malaria Coordinator (currently Rear Admiral Tim Ziemer) who leads the US President’s Malaria Initiative (PMI) housed in the US Agency for International Development (USAID).
One year ago, the United Nations held a high-level meeting on non-communicable disease (NCD) prevention and control that culminated in a General Assembly Resolution 66/2 to adopt a 13-page “political declaration” to “address the prevention and control of non-communicable diseases worldwide.” The event presented a united front against NCDs and its flashiness garnered lots of media attention. But one year later, where has the attention and commitment to NCDs gone?