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The Global Health Policy Research Network (GHPRN) brought together leading experts in public health, economics, and other social science and technical fields to develop original, focused research on high-priority global health policy issues. The GHPRN worked to improve outcomes by providing better evidence, bringing new perspectives into health policy analysis, and supporting the development of innovative solutions to financing and other issues.
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?
The South African government is currently discussing various alternative approaches to the further expansion of antiretroviral treatment (ART) in public-sector facilities. Alternatives under consideration include the criteria under which a patient would be eligible for free care, the level of coverage with testing and care, how much of the care will be delivered in small facilities located closer to the patients, and how to assure linkage to care and subsequent adherence by ART patients.
Donors play a significant role in funding medicines and other commodities in global health. Of the approximately US $28.2 billion spent by donors in 2010, approximately 40% went towards medicines, vaccines and other health commodities, mainly in sub-Saharan Africa. The efficiency of this spend is therefore of great concern, given the large variability in supply chain costs.
U.S. global AIDS spending is helping to prolong the lives of more than a million people, yet this success contains the seeds of a future crisis. Escalating treatment costs coupled with neglected prevention measures mean that AIDS spending is growing so rapidly that it threatens to squeeze out U.S. spending on other global health needs, even to the point of consuming half of the entire U.S. foreign assistance budget by 2016. Mead Over argues that AIDS treatment spending could quickly become a global entitlement since withdrawing funding for life-saving drugs would mean death for the beneficiaries. He offers suggestions for avoiding a ballooning AIDS treatment entitlement, including greatly stepped-up prevention efforts.
Rena Eichler, Ruth Levine and the Performance-Based Incentives Working Group
Donor spending on global health has surged, yet for many poor people in developing countries even basic prevention and treatment remain elusive. CGD’s newest book, Performance Incentives for Global Health: Potential and Pitfalls, shows how modest payments in cash or kind can get more health from health care spending. Informed by case studies and the Working Group on Performance-Based Incentives, co-authors Rena Eichler and CGD vice president Ruth Levine tell how to design and implement effective incentive programs—and what to avoid.
Millions Saved: Proven Success in Global Health details 17 cases in which large-scale efforts to improve health in developing countries have succeeded, saving millions of lives and preserving the livelihoods and social fabric of entire communities.
Donors are considering committing in advance to purchase vaccines against diseases concentrated in low-income countries to spur research and development on vaccines for neglected diseases. How much money is needed? The authors of this paper find that a commitment comparable in size to the average sales of recently launched commercial products (adjusted for lower marketing costs)—about $3 billion per disease when products are at a relatively early stage in development —would be a highly cost-effective way to address major killers, such as malaria, tuberculosis and HIV/AIDS. The paper includes a link to a Web-based spread sheet for readers to conduct their own sensitivity analysis.Learn more
It’s too early to know how large the economic impact of Ebola will be on West Africa and the world. Past experience, including the 2002-03 Severe Acute Respiratory Syndrome (SARS) epidemic, suggest it could be very large indeed, especially in the African countries that have been hardest hit. Fortunately, actions that the US and other donor countries take now could help not only to control the epidemic but also to minimize the economic fallout.