Tag: Priority-Setting


New Initiative to Support Priority Setting for Universal Health Coverage

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Universal health coverage (UHC) is now firmly on the global health agenda, and carries with it the ambitious goal of providing “access to key promotive, preventive, curative and rehabilitative health interventions for all at an affordable cost.”  So where do we start?  A critical first step to delivering on the aspirations of UHC is deciding which services and policies to prioritize and make available.  While resources for health care are growing, they are not infinite and hard choices must be made.  

How Much Health Foregone?

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When national governments or global health funders have to decide whether to subsidize a new medical technology (a new vaccine, a new AIDS medication, a new clinical pathway), some ask whether the new technology is “cost-effective”, that is, whether the health gains from the introduction of the new technology outweigh the health given up or foregone as other activities are displaced to accommodate the additional costs.

Better Drug Use, Greater Efficiency

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As governments across the world expand population access to health care, they are feeling the pressure of rising costs. According to the IMF, emerging economies will spend an additional 1.5 percentage points of GDP on health care over the next 20 years, most of which will come from excess cost growth – defined as health care cost growth related to new medical technologies and income growth, rather than aging.

Health Technology Assessment in the Americas

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This is a joint post with Kate McQueston.

"Every country, no matter how wealthy or how impoverished, cannot afford to waste money in healthcare on health technology that does not contribute to health."

These words were spoken by Harvey V. Fineberg, the President of the Institute of Medicine, at a recent event co-hosted by CGD and PAHO, which highlighted the importance of supporting health technology assessment (HTA) in the Americas. Low-and middle-income countries are increasingly interested in building capacity for priority setting, particularly in regards to public funding in a time where pressures to incorporate costly new technologies are on the rise and donor contributions are stagnating. Over the past five years Brazil, Chile, Costa Rica, Colombia, Croatia, Estonia, the Republic of Korea, Malaysia, and Uruguay have also added health technology assessment agencies—tasked with varying responsibilities, including the generation or coordination of health technology assessment and budget impact analysis, as well as the creation recommendations for coverage or reimbursement decisions related to public spending.

A $400,000 Drug and Why It Matters for Global Health

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This year, Revista Epoca reported that a man named Rafael Favaro sued the government of Brazil to obtain public subsidy for lifetime treatment of a rare form of anemia (PNH). His treatment—Soliris—costs Brazilian taxpayers approximately $440,000 per year and is among the most expensive medicines in the world. Most US insurers do not cover the medicine, only Quebec funds the medicine in Canada, and Scotland does not provide any subsidy.

Making Priority-Setting a Priority for Global Health

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This week the World Health Organization made dementia a priority, while Jim Kim—next in line for the World Bank—chose his as job creation. “Priority” is a word that is often used in global health and development when calling for increased attention to or funding of specific diseases, services, or interventions. But when facing a limited budget (as most low- and middle-income countries are) how can countries best sort multiple priorities into effective, sustainable policies?

Separating the Good from the Bad on HPV

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This week AP reports that former U.S. President George Bush has launched the Pink Ribbon Red Ribbon project in Zambia. The project will expand the availability of cervical cancer prevention, screening and treatment, including the HPV vaccine, by building on the PEPFAR platform for HIV care.

Are We Ready to Set Priorities for an AIDS-Free Generation?

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Yesterday I attended the USAID and World Bank sponsored debate on “Treatment as Prevention,” where debaters were asked to support or oppose the proposition that countries should spend the majority of flat or declining HIV prevention budgets on “treatment as prevention”, building off the results of the HPTN 052 study which found a relative reduction of 89% in the total number of HIV-1 transmissions resulting from the early initiation of antiretroviral therapy.

Priority-Setting at WHO

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WHO’s Executive Board met last month to review progress on reforms at the agency. Among the documents distributed to the Board, there is a report on plans for priority-setting amongst the WHO’s 213 projects run by 8 organizational divisions and 15 regional and special offices.

Everyone agrees that WHO should set priorities in an era of declining resources and eroding purchasing power, but how?

The Director-General’s report is an early effort to figure this out.