What donors can learn from the Global Polio Eradication Initiative’s transition

Policy Blog
Our Policy Associate, Kaci Kennedy McDade, attended the 2019 World Health Summit in Berlin. This blog is her reflection on the Summit. At the World Health Summit last month, I attended a session on finishing the last mile of polio eradication. At the session, panelists described the remarkable gains that have been made over the last three decades. For example, since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, poliovirus cases have decreased by over 99% and polio remains endemic in only three countries (Afghanistan, Nigeria, and Pakistan). Although we have not yet achieved global polio eradication, a key topic of the discussion that may have surprised some attendees was transition. By transition, I mean the phase-out and withdrawal of polio-focused support. While some participants may have…
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Financing Global Public Goods for Health: How Can We Make the Case?

Policy Blog
On September 19, 2019, our Center Director Gavin Yamey gave a video presentation at the 5th Annual Public Policy Conference in the Philippines. The conference was called “Navigating the New Globalization: Local Actions for Global Challenges.” Dr. Yamey’s presentation was on financing global public goods for health.  The blog below is an updated version of his talk. I am delighted to have the opportunity to talk to you today about financing of what we at the Center for Policy Impact in Global Health call “global functions,” and what the World Health Organization (WHO) is calling global common goods for health. The work that I will be presenting today is part of a new program of work led by the WHO on Financing Common Goods for Health, published in a special…
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What makes a successful international global health or development commission?

Policy Blog
Our Center Director Gavin Yamey is chairing the Advisory Board for the new Lancet Commission on Hearing Loss.  Yesterday, at the first meeting of the Commission, hosted by Duke University, he gave a 10-minute talk on what makes a successful international global health or development commission. Below we post his talk. Last year, I led the writing of a peer-reviewed paper published in the journal Health Policy & Planning called “How to Convene an International Health or Development Commission: Ten Key Steps.” The authors were all involved in Global Health 2035: A World Converging in a Generation, aka the Lancet Commission on Investing in Health (the CIH). Three of us—myself, Larry Summers, and Dean Jamison—were commissioners and one of us, Jessica Brinton, was from the Bill & Melinda Gates Foundation,…
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How do global health academics “reach the people”?

Latest News from the Center, Policy Blog
Today, at the Triangle Global Health Consortium annual conference, our Center Director Gavin Yamey was a panelist on a panel called “Reach the People: How to Communicate Global Health Issues and Solutions.” Below, we post his 10-minute panel presentation. In the next 10 minutes, I’m going to try and answer the question: How does a global health academic like me “reach the people”? I’m taking a bit of liberty in thinking about who “the people” are.  I direct a global health policy center at Duke, and for us our key engagement is with a broad array of policymakers – global health funders, foundations, ministries of health and finance, NGOs, and so on. We want our analytic work to influence the conversations, the debates, the dialogue among these global health actors.…
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Donor approaches to health aid transitions: Gavi and PEPFAR

Policy Blog
Many former low-income countries are developing their economies and becoming capable of self financing their health systems. External donors are responding to this shift in varied ways: some have developed exit strategies based on reaching pre-determined milestones while others have shifted programmatic areas of focus and funding levels to respond to a country’s context specific needs. As countries continue to develop their capacity to become more self-reliant, how will donors respond in turn? Will these donor responses enable countries to sustainably continue to advance? Could such responses, if not properly prepared for, slow or even reverse progress? To understand and build the knowledge base around this phenomenon, known as transitions from health aid, we are publishing a series on how seven major global health funders are approaching transition. The seven…
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Are the multilaterals ready to act on pandemic prevention and other global public goods?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors, Kaci Kennedy McDade and Gavin Yamey have authored a working paper “Aligning multilateral support for global public goods for health under the Global Action Plan" Later this month, leaders from across the world will gather in New York for the United Nations General Assembly. During the U.N. High-level Political Forum, the Global Action Plan for healthy lives and well-being for all will launch. Announced at the 2018 World Health Summit, the Global Action Plan is a historic commitment by 12 major multilateral health and development organizations to join forces to help achieve the Sustainable Development Goals (SDGs). Specifically, signatories to the Global Action Plan agreed to align their efforts, accelerate progress in key areas, and enhance accountability across common…
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How do major health donors prepare for country exits?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors, Kaci Kennedy McDade, Osondu Ogbuoji, Marco Schäferhoff, and Gavin Yamey have authored a review “Health aid in transition: a review of the Global Fund to Fight AIDS, Tuberculosis, and Malaria." Many development donors use country income levels—typically gross national income per capita—to ensure that their support for health systems in the developing world goes to countries with the greatest need. As a result, donors often reduce support when countries graduate from low- to middle-income status. While this graduation reflects advancement in economic development and is cause for celebration, transitions away from donor assistance for health typically bring significant challenges for middle-income countries. The evidence also appears to indicate that countries that are expected to graduate from multilateral health assistance…
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The “4 Ds” that Threaten Middle-Income Countries

Policy Blog
This blog was first published in Global Health NOW June 26, 2019. The authors, Shashika Bandara, Kaci Kennedy McDade, Hanna Huffstetler, and Wenhui Mao are major contributors to the 4Ds project at the Center.   In the last 2 decades, more than 30 countries moved from low-income to middle-income status, a billion people were lifted out of poverty, and there were major reductions in maternal and child mortality globally. Despite this progress, middle-income countries, where over 70% of the world’s population now live, are facing unprecedented challenges. The progress they’ve made is threatened. In particular, 4 key phenomena—which we call the 4Ds of global health transition—are rapidly reshaping the nature of health in MICs: Disease: The global burden of disease is shifting away from infections toward non-communicable diseases and injuries. In many…
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Measuring the gap between ability and effort in domestic revenue mobilization

Latest News from the Center, Policy Blog
This blog was first published in Brookings Future Development Blog. The authors, Ipchita Bharali and Indermit Gill have authored a policy brief and a report "Enhancing domestic revenues: constraints and opportunities" available for download here. Developing countries should expect foreign aid to fall during the transition from low to middle income, and end soon after. In low-income countries, the share of foreign aid is about 2.5 percent of GDP. This drops to 0.8 percent in lower-middle-income economies; by upper-middle-income levels, it is a negligible 0.2 percent. For both givers and receivers of foreign assistance, one of the main concerns is that foreign aid weakens the incentives to build domestic revenue administration capacity and make sensible tax policy choices. The stakes can be high. Even a pre-announced and gradual reduction of foreign…
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