05Mar 2019 by slb118@duke.edu

Is trade with India changing Africa’s health care landscape?

Latest News from the Center, Policy Blog, Stories from Africa Seminar Series
This blog was first published in Brookings Future Development Blog and is part of an ongoing series of blogs based on the Stories from Africa Seminar Series that concluded in November 2018 at Duke University. Two of the authors, Siddharth Dixit and Chinmoy Kumar, along with Indermit Gill, have authored a related recent paper "Are Economic Relations with India Helping Africa?" available for download here. African countries face numerous challenges in health services, from severe shortages of health care professionals to weak leadership and governance to limited infrastructure and resources to self-imposed policy barriers. In recent years, trade in the health sector has provided some solutions, such as eHealth (the use of information and communication technologies for health) and mHealth (the use of mobile devices for health). But there is still a long way to go…
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01Mar 2019 by slb118@duke.edu

Stories from Africa: Closing Africa’s health financing gap

Latest News from the Center, Policy Blog, Stories from Africa Seminar Series
This blog was first published in Brookings Future Development Blog and is part of an ongoing series of blogs based on the Stories from Africa Seminar Series that concluded in November 2018 at Duke University. The Sustainable Development Goal (SDG) health targets are extremely ambitious. They call for ending the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases, and preventable deaths of newborns and children below 5 years of age by 2030. Achieving these targets will require large sums of money. Karin Stenberg and colleagues estimate that among 67 low-income countries (LICs) and middle-income countries (MICs)—representing 95 percent of the population of all LICs and MICs—the annual financing gap to reach the SDG health targets is more than $370 billion. About half of these countries are in sub-Saharan Africa, where the…
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02Feb 2019 by slb118@duke.edu

Stories from Africa: Achieving Health Gains on the Way to Universal Health Coverage

Latest News from the Center, Policy Blog, Stories from Africa Seminar Series
This blog was first published in Brookings Future Development Blog and is part of an ongoing series of blogs based on the Stories from Africa Seminar Series that concluded in November 2018 at Duke University. Health leaders and policymakers around the world have a shared interest and commitment to achieve universal health coverage (UHC) by 2030. Health systems are responding to increased demand due to population growth, aging populations with complex conditions, or prior commitments to achieve UHC. Despite health gains in the last 20 years, problems are particularly acute in Sub-Saharan Africa. As economies grow to middle-income levels, they have to tackle communicable diseases while more people are living with non-communicable diseases like diabetes and hypertension. The burden of disease may be higher in low-income economies, but the complexity of…
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28Jan 2019 by slb118@duke.edu

 Reducing out-of-pocket payments for health in order to achieve universal health coverage in Mongolia

Policy Blog
Healthcare costs are among the largest barriers to accessing health services and achieving universal health coverage (UHC) in Mongolia. In 2014, 0.7% or 5,681 households in Mongolia experienced catastrophic health expenditures due to out-of-pocket (OOP) expenses, spending more than 40% of their household subsistence income on health care.1 In this blog, I discuss the origins and impacts of these OOP payments, potential policy solutions and their likely impacts, and the challenges that Mongolia is likely to face in tackling OOP expenses in the future. How Mongolia’s health system has evolved since 1990 Since the early 1990s, when Mongolia transitioned to a market economy, the Mongolian health system has undergone a number of healthcare financing reforms, gradually moving away from the centralized, state-controlled “Semashko-style” model. In 1993, Social Health Insurance (SHI)…
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14Jan 2019 by slb118@duke.edu

Indonesia’s pursuit of universal health coverage: challenges in selecting high-value healthcare and preventing waste

Policy Blog
This was an invited guest blog written by colleagues in Thailand’s Health Intervention and Technology Assessment Program. Health care technologies, including medicines, vaccines, and devices, contribute towards improved health outcomes but are also drivers of the rising costs of healthcare. Therefore, in the interest of sustainability it is essential to assess the value of these technologies on a regular basis. Indonesia, the fourth most populous country in the world, has a prime example of an evolving health system that is facing rising health care costs. This challenge, along with Indonesia’s transition from official development assistance for health and a budget deficit facing the country’s social insurance administration organization (called BPJS), which administers the national health insurance program, have made health technology assessment (HTA) a critically important tool. HTA can help…
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20Dec 2018 by slb118@duke.edu

Always the Bridesmaid…

Latest News from the Center, Policy Blog
The following article was originally featured in the December 2018 issue of  The Medicine Maker magazine. The complete December 2018 issue of the magazine can be found here. You can download the PDF version of this article here ( Article_Always the Bridesmaid) Author: Gavin Yamey ( @GYamey) is the Director of the Center for Policy Impact in Global Health and a Professor of the Practice of Global Health and Public Policy at the Duke Global Health Institute.
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20Dec 2018 by slb118@duke.edu

Development Assistance for Health: 4 Key Developments to Watch for in 2019

Policy Blog
2018 has been a year of many firsts that could help to mobilize global health financing and improve collaboration among global health actors.  Among these firsts, the Global Financing Facility’s (GFF) first replenishment, China’s establishment of its new aid agency, and a global action plan uniting the leading health multilateral agencies together for accelerating progress towards the Sustainable Development Goals (SDGs) stand out. 2019 is also shaping up to be a crucial year for global health development assistance. Here are the top things I’ll be watching in the coming year: Replenishment Mania GFF kicked off the health replenishment cycle in Norway last month with somewhat disappointing results: donors agreed to provide $1 billion to the GFF, achieving half of its target of $2 billion. More pledges may roll in after the…
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19Dec 2018 by slb118@duke.edu

Donor Transitions From HIV Programs: What Is The Impact On Vulnerable Populations?

Policy Blog
This blog was originally published in Health Affairs Blog on December 14, 2018. The original version can be found here.  Many middle-income countries are transitioning away from donor-funded health programs in a range of areas including immunization, maternal and child health, tuberculosis, malaria, and HIV. Unless these donor exits are managed well, they could imperil the sustainability of the remarkable gains that have been achieved over the past two decades in fighting killer infectious diseases and maternal and child health conditions. Donor exits could particularly jeopardize gains in global HIV control. Countries and donors have spent more than $500 billion on HIV programs in low- and middle-income countries over the past two decades, but the gains from these investments are fragile. When donor funding for HIV programs ends, there is an especially acute…
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20Nov 2018 by klk48@duke.edu

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

Latest News from the Center, Policy Blog
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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01Nov 2018 by cnh21@duke.edu

What is Essential Universal Health Coverage?

Latest News from the Center, Policy Blog
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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