Despite the considerable interest in Development Impact Bonds, only a few have reached the implementation phase. We use information from stakeholder interviews to describe the design of one DIB in-depth and use lessons from a range of impact bonds to develop recommendations for potential partners to future DIBs. Lessons from the set of impact bonds reveal a need to reset expectations, particularly around the time and effort needed to develop and market a DIB.
Reproductive Choices to Life Chances: New and Existing Evidence on the Impact of Contraception on Women’s Economic Empowerment
Researchers from many academic institutions and think tanks have studied the relationship between contraception and women's economic empowerment. In both the developing and developed world, the evidence suggests that access to contraception is not only correlated with but can even cause women’s economic empowerment and drive economic growth.
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.
What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.
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.
Nigeria Will Become Polio-Free: Challenges, Successes, and Lessons Learned for the Quest to Eradicate Polio
Despite no reported cases of polio in two years in Nigeria, on August 11, 2016, the WHO announced two new wild polio cases had been discovered in Northern Nigeria. While undoubtedly a setback, Nigeria has mobilized its immunization forces and will look to take heed of four key lessons learned during almost three decades of anti-polio efforts: 1) establishing and sustaining trust is critical to the success of eradication campaigns; 2) frequent, independent monitoring and evaluation are key to tracking the progress of an intervention and making modifications; 3) holding all actors accountable is essential to pushing an intervention forward; and 4) contextualized health initiatives are key in fighting polio and other diseases. These lessons will reinforce a cohesive, multilateral strategy that builds on past successes to secure a polio-free Nigeria.
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.
Attention presidential transition teams: The first hundred days of the new administration should kick start an ambitious agenda in global health alongside long-needed reforms to enhance the efficiency and effectiveness of US action. Building on our earlier work, we suggest seven priority actions within three broad categories.
Since 2015, India has devolved an increasing share of its national tax yield to state governments and undertaken reforms to other kinds of centre-to-state grants. For many, the increased revenue via the tax devolution was considered good news but some health experts worried that states would give little priority to health under these conditions of greater autonomy. We find that at least two states, Bihar and Uttar Pradesh, have much more to spend in general and are budgeting more for health in 2015-2016 as compared to previous fiscal years.
The United States Government has the requisite technical know-how, financial and logistical resources, and bipartisan political support to lead the response to enduring global health challenges, and it is critical that the United States is prepared to meet them. This memo’s six recommendations are the result of a roundtable discussion on how the next administration and Congress can update and improve on the US global health engagement model.
Estimating the Avertable Disease Burden and Cost-Effectiveness in Millions Saved Third Edition - Working Paper 429
Millions Saved (2016) is a new edition of detailed case studies on the attributable impact of global health programs at scale. As an input to the book, this paper provides an independent assessment of the cost-effectiveness of a selection of the cases using ex post information from impact evaluations, with the objective of illustrating how economic evaluation can be used in decision making and to provide further evidence on the extent of health gains produced for the funding provided.
Millions Saved is a collection of success stories in global health—remarkable cases in which large-scale efforts to improve health in developing countries have succeeded.
Global health action has been remarkably successful at saving lives and preventing illness in many of the world’s poorest countries. This is a key reason that funding for global health initiatives has increased in the last twenty years. Nevertheless, financial support is periodically jeopardized when scandals erupt over allegations of corruption, sometimes halting health programs altogether.
Can Access to Contraception Deliver for Women’s Economic Empowerment? What We Know – and What We Must Learn
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.
Making Room for Mental Health: Recommendations for Improving Mental Health Care in Low- and Middle-Income Countries
Development assistance for health has increased dramatically over the last decade, but investment in mental health has been minimal. Less than 1 percent of development assistance for health goes to mental disorders although they represent at least one-fourth of the years lost to disability and about 10 percent of the global burden of disease. Spending a little on mental health could achieve a lot.
On April 7, 2016, CGD’s vice president for programs and director of global health policy Amanda Glassman testified before the Senate Foreign Relations Subcommittee on Africa and Global Health Policy at a hearing examining progress made in addressing the West Africa Ebola epidemic and its secondary effects.
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.
Doing Business Differently with Subnationals: Recommendations for Global Health Donors in Highly Decentralized Countries
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.