Ideas to Action:
Independent research for global prosperity
As countries grow economically, governments face rapidly growing demands for quality, affordable, accessible, and equitable healthcare and other social services. At the same time, many middle-income countries face the prospect of transitioning away from donor aid, adding pressure to already-constrained public budgets to fill gaps as donor support ramps down.
With a vision of “creating equal access to new and underused vaccines,” Gavi set several coverage-specific targets for 2020 as part of its Phase IV strategy, including the immunization of an additional 300 million children, increased pentavalent 3 and measles-containing vaccine (MCV) 1 coverage, and greater equity in coverage across wealth quintiles. In this note, we explore these coverage challenges in greater detail and offer recommendations for how Gavi can address them in its 5.0 strategy.
In this note, we summarize the changing context and its relevance for Gavi, exploring the specific issues relevant to transitioning countries, never-eligible MICs, and countries dealing with complex emergencies or large-scale protracted displacement. We then offer four recommendations to increase Gavi’s relevance and effectiveness in a changing world.
In this note, we diagnose key challenges that will strain Gavi’s model during the 2021–2025 period and beyond. We then offer recommendations for an evolving approach, which closely align with Gavi’s goal to maximize the impact of countries’ current and future domestic investments.
In this note, we highlight the results of Gavi HSS evaluations, how Gavi has responded to identified challenges and limitations in the HSS proposal and implementation process, and what options are available to enhance the effectiveness of HSS support for Gavi’s core mandate. We also discuss the importance of 4G (Gavi, the Global Fund, the Global Financing Facility, and the World Bank Group) collaboration.
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. An accompanying note looks at the full set of issues through a country lens.
In this note, we explore certain global health security considerations and propose procedural improvements or adaptations to Gavi’s mandate to better support the needs of country governments and other partners.
Next week, Women Deliver—the world’s largest conference on gender equality and the health, rights, and wellbeing of women and girls—will kick off. This note highlights three issues for the global FP movement post-2020. We review the underlying critical assumptions in FP2020’s initial design along with their strengths and weaknesses, and place future approaches squarely within the context of today’s evolving landscape—one that looks very different than the year 2012, when FP2020 was launched.
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.
In October, world leaders renewed their commitment to Primary Health Care. Now is an opportune time to identify lessons learned and key challenges from the past 40 years, and to acknowledge the work that remains to be done to make vision reality.
Are USAID programs high impact and good value for money? Do they work? Do they generate more results for less cost than if the agency just gave poor people cash? We don’t always know the answers to those questions, but USAID is trying to find out.
The international family planning community has made impressive gains in increasing global access to high-quality, voluntary family planning services. However, significant challenges remain with maintaining current support and meeting the growing need projected for family planning services and commodities across low- and middle-income countries (LMICs).
Front and center in discussions around the reform and redesign of the United States Agency for International Development (USAID) are the objectives of increased efficiency and effectiveness. The agency’s new administrator, Mark Green, who has highlighted these goals from day one, has an excellent opportunity to improve the agency’s efficiency and effectiveness through better generation and use of evidence to inform policy and programming decisions.
Theory and some empirical evidence suggest the two goals – reproductive rights for women and women’s economic empowerment – are connected: reproductive rights should strengthen women’s economic power. But our understanding of the magnitude of the possible connection and the nature of any causal link (vs. coevolution or reverse causation) in different times and places is limited. In this note we summarize what we know up to now and what more we could learn about that connection, and set out the data requirements and methodological challenges that face researchers and policymakers who want to better understand the relationship.
In the big decentralized countries where global disease burden is concentrated, such as India and Indonesia, most public money for health isn’t spent by the national ministry of health, the traditional counterpart for global health funders and technical agencies. Instead, most money is programmed and spent subnationally.
Greater subnational public spending reflects growing democratization, power-sharing, and local self-determination. It also responds to the conviction that local decision-makers understand local realities better than a bureaucrat sitting in the capital city. Yet evidence on the effectiveness of subnational spending on health care and outcomes is mixed at best, and incentives for greater spending and better performance can be weak.
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