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With shifting disease burdens, growing uncertainties about the future of development assistance for health, and rising demands for more expensive and complex healthcare comes the need for a greater focus on value for money. International health funders and agencies want to know how to make resources stretch further by focusing on the highest impact interventions among the most affected populations. Whether through more efficient procurement systems and supply chains, results-based financing, or more detailed assessments of the effectiveness of health technology, CGD’s work aims to make health funding go further to save, prolong, and improve more lives.
The majority of the world’s sick live in middle-income countries (MIC) – mainly Pakistan, India, Nigeria, China and Indonesia (or PINCI), according to new data from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. Sound familiar? Andy Sumner, Denizhan Duran, and I came to the same conclusion in a 2011 paper, but we used 2004 disease burden data, which didn’t provide an up-to-date view of reality. So I was pleased to see that our findings still hold based on IHME’s 2010 Global Burden of Disease (GBD) estimates.
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 week the World Health Organization held a major international meeting on universal health coverage (UHC), with Director General Margaret Chan reaffirming her regard for universal coverage “as the single most powerful concept that public health has to offer.” While the term “universal” signals that the entire population will be “covered,” an unanswered question is: covered with what? Another way to put the question: What health benefits or interventions would represent coverage, taking into account UHC’s implicit goals of improved health, equity and financial protection?