Category: 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…

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…

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…

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…

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)…