This paper uses contract theory to suggest simple contract designs that could be used by the Global Fund. Using a basic model of procurement, we lay out five alternative options and consider when each is likely to be most appropriate. We ultimately provide a synthesis to guide policy makers as to when and how 'results-based' incentive contracts can be used in practice.
Global Health Donors Viewed as Regulators of Monopolistic Service Providers: Lessons from Regulatory Literature - Working Paper 424
Controlling healthcare costs while promoting maximum health impact in the recipient countries is one the biggest challenges for global health donors. This paper views global health donors as the regulators of monopolistic service providers, and explores potential optimal fund payment systems under asymmetric information. It provides a summary and assessment of optimal price regulation designs for monopolistic service providers.
The Cost and Cost-Effectiveness of Alternative Strategies to Expand Treatment to HIV-Positive South Africans: Scale Economies and Outreach Costs - Working Paper 401
The South African government is currently discussing various alternative approaches to the further expansion of antiretroviral treatment (ART) in public-sector facilities. Alternatives under consideration include the criteria under which a patient would be eligible for free care, the level of coverage with testing and care, how much of the care will be delivered in small facilities located closer to the patients, and how to assure linkage to care and subsequent adherence by ART patients.
Antiretroviral Therapy Awareness and Risky Sexual Behaviors: Evidence from Mozambique - Working Paper 239
In this paper, the authors set out to study how increased access to antiretroviral therapy affects sexual behavior in Mozambique. The researchers found that greater access to antiretroviral therapy led Mozambicans to perceive HIV/AIDS as less dangerous and to engage in more risky sexual behavior. The authors conclude that prevention programs must include educational messages about antiretroviral therapy in order to temper changing beliefs about HIV.
Food Crisis, Household Welfare, and HIV/AIDS Treatment: Evidence from Mozambique - Working Paper 238
Using panel data from Mozambique collected in 2007 and 2008, the authors explore the impact of the food crisis on the welfare of households living with HIV/AIDS. While HIV households have not suffered more from the crisis than others, infected people who experienced a negative income shock also expereinced a reduction or a slower progression in outcomes when treating their illness.
How to Pay “Cash-on-Delivery” for HIV Infections Averted: Two Measurement Approaches and Ten Payout Functions - Working Paper 210
This paper proposes a cash-on-delivery approach to reward AIDS programs in accordance with the number of verifiable HIV infections they avert.
AIDS Treatment in South Asia: Equity and Efficiency Arguments for Shouldering the Fiscal Burden When Prevalence Rates Are Low - Working Paper 161
Senior fellow Mead Over estimates the effect of AIDS on poverty in South Asia and analyzes public policy options to help the region’s predominantly private health care systems meet the challenge of treating AIDS. He finds that South Asian governments should play a larger role in AIDS treatment than in other aspects of health care, in the interest of both efficiency and equity.
Prevention Failure: The Ballooning Entitlement Burden of U.S. Global AIDS Treatment Spending and What to Do About It - Working Paper 144
U.S. global AIDS spending is helping to prolong the lives of more than a million people, yet this success contains the seeds of a future crisis. Escalating treatment costs coupled with neglected prevention measures mean that AIDS spending is growing so rapidly that it threatens to squeeze out U.S. spending on other global health needs, even to the point of consuming half of the entire U.S. foreign assistance budget by 2016. Mead Over argues that AIDS treatment spending could quickly become a global entitlement since withdrawing funding for life-saving drugs would mean death for the beneficiaries. He offers suggestions for avoiding a ballooning AIDS treatment entitlement, including greatly stepped-up prevention efforts.