The global public health response to COVID-19 is pivoting from high-income European countries to MICs predominantly in Asia and South America. Effective test, trace, and isolate systems may be particularly valuable in MICs, where social and economic circumstances do not support large and long-term lockdowns. But investing in such systems in MICs comes with a number of limitations and opportunity costs.
Diagnostic testing is at the center of the policy debate around COVID-19 interventions in India. As of June 1, 2020, India had conducted approximately 3.8 million tests since it began testing in February, but many experts have noted that testing capacity is still drastically insufficient for the needs of the population.
Leave No One Behind: Using a Benefit-Based Advance Market Commitment to Incentivise Development and Global Supply of COVID-19 Vaccines
The global effort to control the COVID-19 pandemic has seen an exceptional allocation of public and philanthropic funds to advance the development of diagnostics, therapeutics, and vaccines as quickly as possible. While critical, even these significant commitments represent only a “down payment” on a price tag that could eventually exceed $50 billion just to scale the production of vaccines to control this global pandemic—amounts that cannot be raised through traditional donor and philanthropic commitments.
Financing and Scaling Innovation for the COVID Fight: A Closer Look at Demand-Side Incentives for a Vaccine
As the COVID-19 pandemic accelerates, global leaders are quickly realizing that we need a bigger, better toolbox to effectively fight the novel coronavirus.
As the UK undertakes “the biggest review of Britain's place in the world since the end of the Cold War,” our experts explore how global health could be incorporated into the integrated review.
Unpacking the Black Box of Payer Policy: A Demand-Side Approach for Equitable Uptake of Cost-Effective Health Innovation
Over the past two decades, global health innovation has delivered important new tools for use in low- and middle-income countries (LMICs) and saved many lives. Nonetheless, the current innovation ecosystem suffers from significant limitations that are likely to worsen with aid transition.
The market-driven, value-based advance commitment (MVAC) builds on the advance market commitment (AMC) mechanism previously used in global health with several important innovations and improvements. Most crucially, the MVAC is driven by MIC demand rather than donor contributions; is informed by countries’ ability to pay rather than a single, “cost-plus” price; and allows pharmaceutical companies to reap higher revenues from a more effective product. In this report, we apply our new model—the MVAC—to a target product profile (TPP), published by the World Health Organization (WHO) in 2016 and endorsed by BMGF, for a pan-TB regimen.
Global health interventions, like many public policies, are rife with uncertainty. Will a program, such as a malaria prevention strategy that looks strong on paper, work as intended? Will a new technology, such as a specific drug or device that appears effective in clinical trial settings, work in practice and provide good value-for-money?
As Health Secretary Matt Hancock returns to his role as part of Boris Johnson’s premiership, he has an opportunity to make good on the UK’s renewed confidence and ambition by drawing on what the new prime minister calls the “best healthcare [system]” to drive improvements in health globally.
Modicare Post-Election: Recommendations to Enhance the Impact of Public Health Insurance on UHC Goals in India
Hailed as one of the largest publicly funded health insurance programs in the world, India’s “Modicare” has, since its launch a little more than six months ago, made universal healthcare coverage an election theme for the first time in the country’s history.
Using publicly available information, we describe all seven DIBs, and evaluate the three “health DIBs” in more detail, comparing their stakeholders, implementation, and outcome structures. We offer three recommendations to improve evaluation and inform development of DIBs in the future.
Perspective in Economic Evaluations of Healthcare Interventions in Low- and Middle-Income Countries: One Size Does Not Fit All
As developing nations are increasingly adopting economic evaluation as a means of informing their own investment decisions, new questions emerge. The right answer to the question “which perspective?” is the one tailored to these local specifics. We conclude that there is no one-size-fits-all and that the one who pays must set or have a major say in setting the perspective.
Healthcare Systems as Intelligent Payers: What Can the Global Health Community Learn from the English National Health Service?
Today, politicians are under growing pressure to squeeze more out of every dollar and guarantee greater access to better, more affordable healthcare for their citizens. In such a resource-constrained environment, wasting trillions of dollars on health every year is not viable. This note provides an overview of some of the approaches and policy options that the National Health Service in England has been using to maximise value for money.
This post previews preliminary answers to one initial question: what can we say about the size and nature of health commodity markets in low- and middle-income countries? We share early insights; list the data sources we used, while also signalling others we hope to draw on going forward; and highlight our assumptions and caveats.
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.
What’s In, What’s Out: Designing Benefits for Universal Health Coverage: Key Messages for Donors and Advocates
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.
Decisions about which type of patients receive what interventions, when, and at what cost often result from ad hoc, nontransparent processes driven more by inertia and interest groups than by science, ethics, and the public interest. Reallocating a portion of public and donor monies toward the most cost-effective health interventions would save more lives and promote health equity.