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.
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.
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.
Mental illnesses are among the top causes of disability and disease in low- and middle-income countries (LMIC). Yet despite the enormous burden that mental ill-health imposes, mental health care remains a truly neglected area of global health policy.
Donors play a significant role in funding medicines and other commodities in global health. Of the approximately US $28.2 billion spent by donors in 2010, approximately 40% went towards medicines, vaccines and other health commodities, mainly in sub-Saharan Africa. The efficiency of this spend is therefore of great concern, given the large variability in supply chain costs.
More than ever, global health funding agencies must get better value for money from their investment portfolios; to do so, each agency must know the interventions it supports and the sub-populations targeted by those interventions in each country. In this study we examine the interventions supported by two major international AIDS funders: the Global Fund to Fight AIDS, Tuberculosis, and Malaria (‘Global Fund’) and the President’s Emergency Plan for AIDS Relief (PEPFAR).
Performance-based financing can be used by global-health funding agencies to improve program performance and thus value for money. The Global Fund to Fight AIDS, Tuberculosis and Malaria was one of the first global-health funders to deploy a performance-based financing system. However, its complex, multistep system for calculating and paying on grant ratings has several components that are subjective and discretionary. We aimed to test the association between grant ratings and disbursements, an indication of the extent to which incentives for performance are transmitted to grant recipients.
Little is known about the President’s Emergency Plan for AIDS Relief (PEPFAR) financial flows within the United States (US) government, to its contractors, and to countries. We track the financial flows of PEPFAR – from donor agencies via intermediaries and finally to prime partners. We reviewed and analyzed publicly available government documents; a Center for Global Development dataset on 477 prime partners receiving PEPFAR funding in FY2008; and a cross-country dataset to predict PEPFAR outlays at the country level. We present patterns in Congressional appropriations to US government implementing agencies; the landscape of prime partners and contractors; and the allocation of PEPFAR funding by disease burden as a measure of country need.
The authors carry out a systematic review of studies on CCTs that report maternal and newborn health outcomes, including studies from eight countries. We find that CCTs have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers, and reduced the incidence of low birth weight. The programs have not had a significant impact on fertility or Caesarean sections while impact on maternal and newborn mortality has not been well documented thus far.
In this paper, the authors discuss the rationale for investing in vaccination and construct a metric to measure country commitment to vaccination that would promote accountability and better tracking of performance.
In this joint report, Thomas J. Bollyky, CFR senior fellow for global health, economics, and development, and Amanda Glassman, director of global health policy at the Center for Global Development, propose applying Cash-on-Delivery (COD) Aid as a new incentive mechanism for tobacco control in low- and middle-income countries.