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Incorporating Economics and Modelling in Global Health Goals and Guidelines

A Working Group convened by the Center for Global Development, Thanzi la Onse, and The HIV Modelling Consortium

International organizations influence national-level health sector priorities by affecting how much funding is available for healthcare delivery within countries and setting limits on how that funding is used. They exert particular influence in setting disease-specific targets, developing clinical guidelines, and using investment cases. But for the most part, the processes they follow in undertaking these activities do not account for limited country resources or the other uses those resources could be put to. The Center for Global Development, Thanzi la Onse, and the HIV Modelling Consortium launched a working group on Economics in Global Health Goals and Guidelines. The working group engaged key global health stakeholders—international organizations, national policymakers from LMICs, researchers, and others—to reflect on the use of economics in international guideline- and target-setting (in addition to other international priority-setting processes). We aimed to develop recommendations to help global health organizations ensure their actions lead to the greatest population health gains within the limited means available, with a final report now available.

Healthcare funding and allocation decisions often depend upon complex interactions between numerous stakeholders. In low- and middle-income countries, international organizations may hold substantial sway over prioritization decisions by providing financial and technical assistance to facilitate policy or program change to support the attainment of targets or adoption of guidelines. The actions of international organizations have certainly resulted in tremendous disease-specific health gains; however, it has been argued that current processes hinder efforts to maximize population health by channeling resources toward few health concerns, which may not have the greatest effect on population health or be aligned with priorities of national governments and their citizens. For example, the methods behind the development of World Health Organization Guidelines typically result in recommendation of interventions that have the greatest individual-level benefit (i.e. greatest benefits to those able to receive interventions), but do not necessarily minimize morbidity and mortality across a population considering limited healthcare resources.

Due consideration should be given to current methods underpinning global health decision-making. Economic analysis and epidemiological modelling could have a paramount role in informing resource allocation; through estimating disease burdens and epidemiologies across populations, the health benefits associated with policy alternatives and their costs; thereby informing priorities in the face of limited budgets and constraints upon healthcare delivery. These disciplines can provide the organizing framework within which a consideration of all relevant evidence is possible. A fresh approach is required and recommendations sought on how the actions of the global health institutions can be guided in a way that is more likely to lead to greatest population health gains from within the limited means available.

Funding has been received from iDSI, RCUK Global Challenges Research Fund (GCRF), and the Bill and Melinda Gates Foundation.

For further information, please contact CGD Visiting Fellow, Paul Revill (previll@cgdev.org), or Amanda Glassman (aglassman@cgdev.org).

Workshop #1 Attendees

Amanda Glassman, Center for Global Development

Andrew Kambugu, Infectious Diseases Institute, Uganda

Andrew Phillips, University College London

Anthony McDonnell, Wellcome Trust 

Carol Levin, University of Washington

Charlie Gilks, University of Queensland

Chutima Suraratdecha, Centers for Disease Control and Prevention

Daniel Klein, Institute for Disease Modelling

David Wilson, Bill and Melinda Gates Foundation

Edward Kataika, East Central Southern Africa (ECSA) Health Community

Eliana Barrenho, Imperial College London

Ellen McRobie, Imperial College London

Gesine Meyer-Rath, HE2RO, Wits University

Ian Weller, University College London

John Stover, Avenir Health

Julie Jemutai, KEMRI-Wellcome Trust Research Programme, Kenya

Katharina Hauck, Imperial College London

Kenneth Katumba, MRC/UVRI, Uganda

Marelize Gorgens, World Bank

Mark Sculpher, University of York

Mead Over, Center for Global Development

Miqdad Asaria, International Decision Support Initiative

Paul Revill, University of York

Rebecca Forman, Center for Global Development

Ruanne Barnabas, University of Washington

Ruth Lopert, George Washington University

Samantha Diamond, Clinton Health Access Initiative

Sergio Bautista, Public Health Institute of Mexico

Stefano Bertozzi, University of California

Tim Hallett, Imperial College London

Tommy Wilkinson, PRICELESS, South Africa

Andrea Ciaranello, CEPAC/Massachusetts General Hospital

Ayako Takemi, Center for Global Development

Elizabeth Chizema, National Malaria Elimination Programme, Zambia

Kalipso Chalkidou, Center for Global Development, London

Krisantha Weerasuriya, Former World Health Organization Essential Medicines

Elizabeth Stuart, Overseas Development Institute

Martin Chalkley, University of York

Nishant Jain, GIZ, India

Ole Norheim, University of Bergen

Rachel Silverman, Center for Global Development

Yot Teerawattananon, HITAP, Thailand

The final report is available here.

Contact

Paul Revill (previll@cgdev.org) Amanda Glassman (aglassman@cgdev.org).

Related Experts

Photo of Amanda Glassman
Executive Vice President of CGD, CEO of CGD Europe, and Senior Fellow
Photo of Mead Over
Senior Fellow Emeritus
Revill photo
Non-Resident Fellow
Photo of Rachel Silverman
Policy Fellow