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With shifting disease burdens, growing populations, and rising expectations comes a greater focus on value for money. International health funders and agencies want to know how to make the most of money spent by focusing on the highest impact interventions among the most affected populations. Whether through better procurement systems for health commodities, results-based financing, or more detailed assessments of the effective ness of health technology, CGD’s work aims to make health funding go further to save, prolong and improve more lives.
At a London conference earlier this month, some donors promised generous funding for family planning services in developing countries. At the same time, however, future support from the US is in doubt, and progress towards the FP2020 family planning goals has been extremely limited. Just how much progress have we made, and how far do we have to go? What difference will the new pledges make, and how should they be used? Rachel Silverman, CGD’s assistant director of global health policy, responds to these questions in this week’s podcast.
Cost-effectiveness analysis (CEA) can help countries attain and sustain universal health coverage (UHC), as long as it is context-specific and considered within deliberative processes at the country level. Institutionalising robust deliberative processes requires significant time and resources, however, and countries often begin by demanding evidence (including local CEA evidence as well as evidence about local values), whilst striving to strengthen the governance structures and technical capacities with which to generate, consider and act on such evidence. In low- and middle-income countries (LMICs), such capacities could be developed initially around a small technical unit in the health ministry or health insurer. The role of networks, development partners, and global norm setting organisations is crucial in supporting the necessary capacities.
India's Ministry of Health is committed to universal health coverage and has announced its plan to provide dialysis in the face of rising kidney failure. But providing dialysis for all who need it could consume the entire public health budget. Policymakers need to evaluate affordable dialysis options, pay systematic attention to the selection of who will receive dialysis, and put more emphasis on prevention.
At the World Bank’s Annual Universal Health Coverage (UHC) Financing Forum this year, I took part in a mock competition to help determine the topic of next year’s forum. I was up against Larry Gostin, who argued that the 2017 forum should focus on equity and human rights, and Sara Bennett, who made the case for it to be the political economy. My pitch was for the forum to focus on efficiency—or value for money—in UHC reforms, and here’s why.