Author: Heather Hille

This blog was first published in Brookings Future Development Blog, March 2, 2021. The authors are Kaci Kennedy McDade, Kenneth Munge, Gilbert Kokwaro, and Osondu Ogbuoji. Health systems in most low- and middle-income countries face two major obstacles: insufficient domestic funding and inefficient use of available resources. While the problem of insufficient domestic funding has partly been mitigated by foreign aid, these arrangements are changing quickly: As countries move from low- to middle-income status, they are perceived as capable of financing their health systems. Some donors have begun to transition out of such middle-income countries. While graduation from foreign aid is a positive milestone for any country, this transition, if poorly managed, may lead to a reversal of health gains. The suspicion is that this is happening in many countries. To…

This blog was first published in Brookings Future Development Blog, February 2, 2021. The authors are Cordelia Kenney, Kaci Kennedy McDade, Wenhui Mao, and Osondu Ogbuoji. Disruptions caused by the COVID-19 pandemic could reverse progress in global poverty reduction and in global health improvements among poor people. The links between health and poverty are clear: Poverty limits people’s ability to access medical care, safe living environments, and sufficient nutrition, the absence of which can have disastrous consequences. Conversely, good health enables employment and income generation. The pandemic will make it harder to achieve the Sustainable Development Goals (SDGs). While 70 percent of the world’s poor already reside in middle-income countries (MICs), the World Bank projects that more than 100 million more people, most of them in MICs, might have fallen below…

This blog was first published in Brookings Future Development Blog, December 1, 2020. The authors are Ashwini Deshpande, Khaing Thandar Hnin, and  Tom Traill. During the first wave of the coronavirus pandemic, from late March to early August, Myanmar recorded just 360 cases and 6 deaths. Early in the crisis, the government rapidly implemented measures to contain the virus. Just as it started easing them though, the country was hit by a major second wave in mid-August. Daily cases increased from less than 10 per day in early August to over 1,000 per day in mid-October. This wave has overwhelmed Myanmar’s inadequate and understaffed health infrastructure. By November 20, there were 76,414 confirmed cases and 1,695 deaths (Figure 1). Figure 1a. Cumulative active confirmed cases, discharged patients and deaths Figure 1b.…

This blog was first published in Brookings Future Development Blog. The authors are Jiaqi Zhang, Justice Nonvignon, and Wenhui Mao. The first two COVID-19 cases in Ghana were confirmed on March 12, 2020. As of July 23, 2020, there have been 32,969 confirmed COVID-19 cases with 168 deaths. The virus has disproportionately affected southern Ghana—52 percent of cases are in Greater Accra (Table 1). With a population of about 30 million—the 10th largest in sub-Saharan Africa—Ghana now has the fourth highest number of cases in sub-Saharan Africa (after South Africa, Egypt, and Nigeria). The reason is that Ghana has one of the highest testing rates when compared to other African countries. Table 1. Half of Ghana’s COVID-19 cases are in and around the capital city Region Cases Greater Accra 17,152 Ashanti…

This blog was first published in Brookings Future Development Blog. The authors are Ipchita Bharali, Preeti Kumar, and Sakthivel Selvaraj. The first COVID-19 case in India was detected on January 30, the same day that WHO declared it a public health emergency of international concern. India went into lockdown almost two months later. On June 8, after 10 weeks of lockdown, India started a phased reopening of its economy. With Unlock 1.0, the country is trying to balance attempts to revive the economy while dealing with increasing caseloads and new hotspots. On June 30, official COVID-19 cases stood at over 585,000, and more than 17,500 deaths (Figure 1). While recovery rates have improved to 60 percent and the death rate is relatively low considering that India is the fourth most-impacted country…

This blog was first published in Brookings Future Development Blog. The authors are Siddharth Dixit, Yewande Kofoworola Ogundeji, and Obinna Onwujekwe. On January 23, 2020, the World Health Organization’s International Health Regulations (IHR) Emergency Committee advised that “all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO.” On January 30, 2020, the WHO declared COVID-19 to be a public health emergency of international concern. Is Nigeria prepared to respond effectively to pandemics? In 2017, during the WHO’s Joint External Evaluation (JEE) of IHR core capacities (an independent, collaborative multi-sectoral effort to assess a country’s capacity to prevent, detect, and respond to public health risks), Nigeria scored poorly both…

This blog is the text of a YouTube live talk given by our Center’s Director, Gavin Yamey, on June 12, 2020. Hello and thank you so much for joining this YouTube live conversation today on Coronavirus: The new normal. My name is Gavin Yamey, I’m a Professor of Global Health and Public Policy at Duke. I direct the Center for Policy Impact in Global Health in the Duke Global Health Institute. To give you a little bit of my background: I’ve had a rather eclectic career—I’m a physician who then became a health journalist who then became a public health researcher—and today I try and wear all three hats at the same time in my work on global health policy. Global health policy essentially means trying to achieve large scale…

In a recently published blog, my friend Dr Abiodun Awosusi narrated this very touching story: “I walked into the paediatric unit of a teaching hospital in Nigeria a few years ago to review a patient. On the first bed was a lifeless child. He was brought in dead a few minutes earlier by his parents. His mother, “Bisi”, wept uncontrollably. While in tears, she recounted how difficult it was for them to borrow money to get to the hospital. Although they got some money from a chief in the community, the two-year-old baby died before they got to the hospital”. Many households such as this one have been pushed into poverty, debt, and financial hardship as a result of seeking health care. In Nigeria, data from the 2017 National Health…

This blog was first published in Duke Global Health Institute News. The author Mary-Russell Roberson. Among sub-Saharan African countries, Ghana stands out for its high rate of health insurance coverage: About 40 percent of the population has policies available through the National Health Insurance Scheme (NHIS). But the NHIS is costing the government more than expected. A proposed cost-saving policy, called capitation, would pay providers per patient rather than for each service provided. The policy looked good on paper, but failed in a pilot program. Gilbert Abiiro wanted to know why. He’s a lecturer/researcher at the University for Development Studies in Ghana, who recently spent eight weeks at Duke as a fellow of the Center for Policy Impact in Global Health. In Ghana, Abiiro interviewed providers, policymakers, politicians, and people who…

This blog was first published in Brookings Future Development Blog. The authors are Gavin Yamey, Marco Schäferhoff, Kaci Kennedy McDade, and Wenhui Mao. On January 30, 2020, the World Health Organization (WHO) determined that the outbreak of the 2019 novel coronavirus (2019-nCoV) that originated in China was a Public Health Emergency of International Concern. Although researchers quickly identified and sequenced the virus, our weak global pandemic preparedness system has led to rising numbers of people infected with 2019-nCoV worldwide. The virus is highly transmissible, and is likely to become a pandemic. WHO has requested $675 million for a coronavirus preparedness and response plan. When a pandemic occurs, global health donors rush to provide a burst of pandemic funding. Then, just as we saw in the wake of past outbreaks like the…