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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.
Vaccinate children against measles and mumps or pay for the costs of dialysis treatment for kidney disease patients? Pay for cardiac patients to undergo lifesaving surgery, or channel money toward efforts to prevent cardiovascular disease in the first place? For universal health care (UHC) to become a reality, policymakers looking to make their money go as far as possible must make tough life-or-death choices like these.
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.
Global health policy enthusiasts will be excited to see that WHO has recently published a draft Concept Note on the 2019-2023 Programme of Work under the stewardship of its new Director-General. We see two glaring missed opportunities: 1) more centrality to universal health coverage (UHC) as an organizing principle for WHO and its work, and 2) more emphasis on enhancing the value for money of public spending on UHC and elsewhere.
Health products—including drugs, devices, diagnostics, and vector control tools—are essential for meeting the healthcare needs of any population. Right now, many low- and lower-middle-income countries rely on donor-managed mechanisms to procure a large share of these health commodities. But this status quo won’t stay static for long, and the global health community must prepare for sweeping changes in global health and procurement over the next 10–20 years. Here’s some of what we see happening now and on the immediate horizon.
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.