Ideas to Action:
Independent research for global prosperity
Gavi’s mission—saving children’s lives and protecting people’s health by increasing equitable use of vaccines—remains highly relevant. Gavi 5.0 needs a new model to deliver on its laudable mission. This overview note lays out five challenges and summarizes some of our ideas to address them; backing up each is a standalone note that provides greater detail and options for action.
In many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most.
Internationally set goals and guidelines directly influence the setting of health care priorities at the national level, affecting how limited resources are generated and allocated across health care needs. The Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines has brought together disease specialists, policymakers, economists, and modelers from national governments, international organizations, and academic institutions across the globe to address these issues, to take stock of current approaches, and make recommendations for better practice.
In July 2012, world leaders gathered in London to support the right of women and girls to make informed and autonomous choices about whether, when, and how many children they want to have. There, low income-country governments and donors committed to a new partnership—Family Planning 2020 (FP2020). Since then, the focus countries involved in the FP2020 partnership have made significant progress. Yet as FP2020 reaches its halfway point, and new, even more ambitious goals are set as part of the Sustainable Development Goals, gains fall short of aspirations.
Founded in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is one of the world’s largest multilateral health funders, disbursing $3–$4 billion a year across 100-plus countries. Many of these countries rely on Global Fund monies to finance their respective disease responses—and for their citizens, the efficient and effective use of Global Fund monies can be the difference between life and death.
Most money and responsibility for health in large federal countries like India rests with subnational governments — states, provinces, districts, and municipalities. The policies and spending at the subnational level affect the pace, scale, and equity of health improvements in countries that account for much of the world’s disease burden: India, Indonesia, Nigeria, and Pakistan.
Hospitals are central to building and maintaining healthy populations around the world. They serve as the first point of care for many, offer access to specialized care, act as loci for medical education and research, and influence standards for national health systems at large. Yet despite their centrality within health systems, hospitals have been sidelined to the periphery of the global health agenda as scarce financial resources, technical expertise, and political will instead focus on the expansion of accessible primary care.
Despite improvements in censuses and household surveys, the building blocks of national statistical systems in sub-Saharan Africa remain weak. Measurement of fundamental statistics such as births and deaths, growth and poverty, taxes and trade, land and the environment, and sickness, schooling, and safety is shaky at best.
PEPFAR is at a critical turning point in its decade-long existence. The next US Global AIDS Coordinator is uniquely positioned to set the course for the program’s future. A change in leadership at the President’s Emergency Plan for AIDS Relief creates an opportunity to ask questions about the organization and reflect in more general terms on the US response to the global AIDS epidemic.
This report offers a strategy for the Global Fund to get more health for the money by focusing more on results, maximizing cost-effectiveness, and systematically measuring performance throughout its operations.
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.
This report of the Rethinking U.S. Foreign Assistance Program summarizes the rationale for continued U.S. investment in global health, looks into the evolution of the Global Health Initiative, and recommends a re-boot for the whole enterprise.
This report of the Working Group on Clinical Trials and Regulatory Pathways provides practical policy recommendations to help provide better, safer, and cheaper medicine and treatment to the 1 billion people suffering from neglected diseases.
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