Ideas to Action:

Independent research for global prosperity

CGD Policy Blogs


Making Markets for Merit Goods

This is a joint post with Josh Busby

Our research on the political economy of antiretrovirals (ARVs) is motivated by a key puzzle: why were AIDS activists and AIDS policy entrepreneurs successful in putting universal access to treatment on the international agenda when so many other global campaigns--whether in health care or other issue areas like climate change--have either failed or struggled to have much impact. In our paper, we make the case that the market for ARVs was politically constructed, meaning that activists had to bring the demand and supply sides of the market together through a variety of tactics and strategies (Tim Bartley makes a similar argument on forest certification schemes).

Motherhood is not a Universal Experience

The difficult birth this week of a new baby girl to one of our staff has reminded us of the stark differences between becoming a mother in the rich world and in the poor world. The difference is not so much that having a baby is without risk for rich-world women: ask your colleagues and neighbors about their own experiences of childbirth and you’ll be surprised how many dramatic stories emerge. In my own case, a flawless pregnancy suddenly turned life-threatening due to pre-eclampsia at 32 weeks gestation.

Is Donor Spending on AIDS a "Gross Misallocation of Resources"?

Our former colleague Jeremy Shiffman has just published an article that concludes with a quote from a 2006 Rwandan government assessment that the share of health support going for AIDS was "grossly disproportionate in a country with a 3% infection rate" and represented a "gross misallocation of resources."

Achieving the Maternal Health MDG: Momentum is Building but Political Challenges Remain

Of all the Millennium Development Goals, progress on the maternal health goal may be the most disappointing. The target is to reduce by three-quarters between 1990 and 2015 the maternal mortality ratio - the number of deaths per 100,000 live births. A study published last week in The Lancet estimates 535,900 maternal deaths in 2005, only a slight decline since the launch twenty years ago of a Global Safe Motherhood Initiative.

Framing a Health Systems Movement?

On Thursday, Jeremy Shiffman joined Maurice Middleberg (Global Health Council), Anne Tinker (Saving Newborn Lives), and Rachel Nugent (Center for Global Development) at a standing-room only event at the Center to discuss a framework explaining why some health initiatives attract global political priority and others are unable to do so.

US Global AIDS Funding Restored: The Highs and the Lows

How often do you get more money than you ask for? Not that often and probably less so when it has to do with helping poor countries to improve their citizens' health. In a surprising but welcome move on January 29th, the House Appropriations Committee filed their joint continuing resolution for FY 2007 to complete the unfinished federal funding bills for the current fiscal year 07. While most programs were funded at FY06 levels a few "High Priority Needs" were selected for increased investments.

HIV/AIDS Control May be Crowding Out Other Health Initiatives

HIV/AIDS control is now receiving enormous attention in global health circles. This is reason both for celebration and concern. It is reason for celebration because the disease has been neglected in the past and the tide may be turning against this humanitarian crisis. It is reason for concern because there is growing evidence that the extensive focus on this one disease is crowding-out resources and policy-maker attention for the many other causes of death and illness of the poor in the developing world.

More Health Workers, Yes. But Only Within Better Systems

*This post is co-authored by Ruth Levine
In the Washington Post today, three doctors with sterling reputations in the AIDS world (Lola Daré, executive secretary of the African Council for Sustainable Health Development International and a member of CGD's working group on IMF programs and health spending; Paul Farmer, pioneer of new AIDS treatment programs in Haiti and Rwanda; and chief of Harvard Medical School's Department of Social Medicine Jim Kim, a member of CGD's working group on the Global Fund), call on the Bush Administration to spend $8 billion on training of community workers, nurses and doctors in Africa to deal with AIDS treatment.
Their proposition that many more community-level health workers be deployed to provide essential services, breaking the implicit and costly monopoly of health "professionals" on health delivery, makes eminent sense. But more money for training, without complementary institutional changes that fundamentally alter the incentives for workers at all levels, won't get the outcomes sought by those who are working on AIDS, or any other health challenges.