Intensified multilateral cooperation on global public goods for health: three opportunities for collective action

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Through a number of collaborative projects with partners such as SEEK Development, UCSF’s Evidence to Policy Initiative, Open Consultants, and Spark Street Consulting, The Center for Policy Impact in Global Health has been studying the “global functions” of donor financing for health. By global functions, we mean collective action activities that address transnational health challenges. These activities can be categorized as (i) global public goods (GPGs), e.g., knowledge generation and sharing, or product development for neglected diseases; (ii) control of negative regional and global externalities, e.g., pandemic preparedness, and (iii) global health leadership and stewardship, e.g., global convening to build consensus. In one study led by our colleague Marco Schäferhoff, we found that there is substantial underinvestment in this critical area: only one-fifth of all donor financing for health targets…
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What is Essential Universal Health Coverage?

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In a new report written by the Lancet Commission on Investing in Health (the CIH), launched at last week’s Alma Ata at 40 meeting, the CIH draws on evidence from the third edition of the Disease Control Priorities (DCP3) to define essential universal health coverage (EUHC). DCP3 was a 7-year international collaboration that synthesized evidence on the most effective way to tackle priority health conditions in low-income countries (LICs) and middle-income countries (MICs). A key output of DCP3 was a set of 21 essential packages of interventions, each one aimed at a different health priority (e.g. reproductive health, pandemic preparedness).  As the CIH notes in the Alma Ata at 40 report: “Interventions were included in these 21 packages if they provided good value for money, were feasible to implement in…
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Let’s End the Fuzziness in Universal Health Coverage

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This Op-Ed first appeared in Global Health Now. [caption id="" align="alignnone" width="850"] The line begins at dawn in Myameyamu, Zambia for a monthly clinic that provides the only essential medical services for miles. Image: © 2012 Malcolm Spence/On Call Africa, Courtesy of Photoshare.[/caption] The global health community is gathering this week in Astana, Kazakhstan, to mark the 40th anniversary of the 1978 Alma Ata conference on primary health care. This time around, primary health care is being framed through the lens of universal health coverage (UHC). While everyone agrees that UHC is the right aspiration, the term has come to mean all things to all people, a catch-all with multiple proposed interpretations. The problem with this fuzzy language is that, without specificity, UHC risks being an empty promise. What does UHC mean, exactly?…
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Tracking financial commitments to women’s, children’s, and adolescents’ health

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One of our key research interests at The Center for Policy Impact in Global Health is studying how money flows through the global health “system.”  We are interested in questions such as where does global health financing come from, through which channels does it flow, where does it end up, and how is it used?  There is an enormous financing gap to achieve the ambitious health-related Sustainable Development Goals (SDGs)—one study suggests that an additional $371 billion is needed annually across low- and middle-income countries—and the tracking of finance flows is critical in knowing whether the gap is being closed.  Just meeting the child and maternal health targets in SDG3 alone is estimated to require an additional $33 billion annually. In recent months, along with our colleagues at Open Consultants…
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10/18/18 EVENT: Stories from Africa Seminar Series

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Stories from Africa Seminar Series Our center received a grant from the Duke Africa Initiative to establish a cross-cutting seminar series jointly organized by four centers at Duke University: The Center for Policy Impact in Global Health (CPIGH), Duke Center for International Development (DCID), Duke-Margolis Center for Health Policy, and the Duke Global Health Innovations Center (GHIC). These seminars will focus on health and economic development issues in Africa. 2nd event: Financing Health in Sub-Saharan Africa What are the key challenges for financing health in Sub-Saharan Africa? Who are the major global health actors and how will donor resources be best used as African countries begin to finance more of their own health needs with domestic resources? How does China’s Belt and Road Initiative fit into the global health landscape in Africa? Gain key insights at the discussion…
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We need breakthrough technologies to reach the Sustainable Development Goal targets for health

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This blog was originally published as part of the Future Development blog series of the Brookings Institution on October 5, 2018. The original version can be found here. Sustainable Development Goal (SDG) 3—ensuring healthy lives and promoting wellbeing for all—is accompanied by a very ambitious set of targets. These include ending avertable child deaths and ending the epidemics of AIDS, tuberculosis (TB), malaria, and neglected tropical diseases by 2030. Are these achievable or can they be dismissed as just a “fairytale”? ARE THE TARGETS ACHIEVABLE? Researchers have tried to answer this question using two complementary approaches. The first is to look at recent trends in death rates and then extrapolate these trends forward to 2030. The second is to model what would happen if today’s health interventions—such as medicines, vaccines, insecticidal…
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The Forum on China-Africa Cooperation Summit: What is it and why does it matter to global health?

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FOCAC: What is it? The Forum on China-Africa Cooperation (中非合作论坛 or FOCAC) is an official forum between China and Africa, with the highest level of engagement taking the form of a summit held every three years. The third FOCAC summit was held in Beijing on September 3-4, 2018 and was attended by heads of government or other top officials from every African country except for eSwatini (formerly known as Swaziland), which retains diplomatic ties with Taiwan. The theme of the 2018 summit was “China and Africa: Toward an Even Stronger Community with a Shared Future through Win-Win Cooperation.” FOCAC Summit 2018: What were the key takeaways? At this year’s forum, President Xi announced that China will provide $60 billion to African countries over the next three years and write off…
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Penny-wise, pandemic-foolish

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This blog was originally published as an editorial in various newspapers including the Times Union on February 8, 2018 and the original version can be found here. A few days ago, I joined several thousand global health practitioners, researchers, activists and policymakers at a conference in Bangkok titled "Making the World Safe from the Threats of Emerging Infectious Diseases."  The audience was abuzz about a new study by a team of economists — including former U.S. Treasury Secretary Lawrence Summers — that shows the staggering economic costs of a future pandemic. They estimate the annual losses from a moderate to severe pandemic would be about $500 billion, or 0.6 percent of global income. That's similar to the annual costs of global warming, double the cost of natural disasters and five…
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Pandemics and the poor

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This blog was originally published as part of the Future Development blog series of the Brookings Institution on June 19, 2017 and the original version can be found here. When epidemics or pandemics hit, they usually hit the poor first and worst. We have known this for a while. The German pathologist Rudolf Virchow described this link between poverty and vulnerability to outbreaks in his 1848 study of a typhus epidemic in Upper Silesia: For there can now no longer be any doubt that such an epidemic dissemination of typhus had only been possible under the wretched conditions of life that poverty and lack of culture had created in Upper Silesia. What we have not known, until recently, is how best to help the poor protect themselves from pandemics. To…
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New Research and Policy Center to Address Future of Financing Global Health

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DURHAM, N.C. -- A new policy lab opening today at the Duke Global Health Institute will address financing solutions aimed at improving the health of the world’s poor. Specifically, the Center for Policy Impact in Global Health will focus on three significant gaps in global health financing: A gap in donor financing for research and development for poverty-related and neglected diseases, and for other “global functions” of health aid, such as pandemic preparedness. Global functions of aid are those that tackle issues that transcend national borders. Donor financing for health has flat-lined in recent years and too little of it has been directed at these global functions. A “middle-income gap,” which arises when countries cross an income threshold and no longer qualify for health aid. Most of the world’s poor…
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