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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.
Many health improving interventions in low-income countries are extremely good value for money. So why has it often proven difficult to obtain political backing for highly cost-effective interventions such as vaccinations, treatments against diarrhoeal disease in children, and preventive policies such as improved access to clean water, or policies curtailing tobacco consumption?
After a successful replenishment earlier this year, the board of Gavi, the Vaccine Alliance, is thinking through how to maximize the impact of the money it has raised. One hot issue is graduation from Gavi support. Currently, the Alliance uses an income cutoff loosely based on eligibility for IDA — soft loans from the World Bank.
India has fallen behind in both health expenditure and health outcomes compared to other lower-middle-income countries. Its burdens of tuberculosis and malaria, and increasingly noncommunicable diseases like diabetes, are one of the largest. Infant mortality and child malnutrition rates rival those in sub-Saharan Africa.
Last September, we released a report on how the Global Fund could get more health for its money. In it, we offered concrete suggestions for improvements in several different value-for-money domains, all with an eye toward maximizing the health impact of every dollar spent.
A health policy decision is only as good as the information available to the decision maker. As countries strive to achieve Universal Health Coverage and funding from local governments and global donors is scrutinized, there is an acute need for more and better economic evaluation to inform government and donor investments in healthcare. To that end, the Bill and Melinda Gates Foundation, one of the largest funders of health economic evaluation in LMIC settings, has partnered with an international collaboration of experts to develop the Gates Reference Case – a principle-based standardised methodology for good practice in the planning, implementation, and reporting of economic evaluation for informing priority setting in health. This session will introduce the principles of the Gates Reference Case, explain how and why the reference case was developed, and what this might mean for the conduct and use of economic evaluation and decision-making in LMIC.
The Gates-RC is an element of the International Decision Support Initiative (iDSI), a platform supported by the UK’s Department for International Development, BMGF, and the Rockefeller Foundation, for engaging with and responding to the growing demand for evidence-informed decision-making processes. iDSI involves a partnership between an increasing number of institutions around the world, including NICE international and the Center for Global Development.