Five big stories from 2006, and perhaps one that didn't get many headlines, stand out as harbingers of what's ahead in 2007.
CGD Policy Blogs
Once again, volatile demand for flu vaccine is giving everyone a headache. A mere two years ago supply fell badly short of demand, turning US seniors into "immunization tourists" to Canada, and putting President Bush on the defensive during the 2004 campaign. This year, demand is way off, and suppliers can barely give the vaccine away; they face the prospect of wasting valuable doses because the vaccine is developed specifically for this year's strain.
In the latest issue of Finance & Development, George Schieber, Lisa Fleisher and Pablo Gottret argue - correctly, in my view - that low government spending is only the tip of the iceberg when it comes to financing basic health services and social protection in low-income countries: it's not just a question of "how much money," but also of who pays and how it's spent.
The real world just refuses to cooperate with earmarks. That's the conclusion to be drawn from the article in the latest Economist highlighting the links between the natural histories of AIDS and malaria. The article drew attention to a study published in Science, by Laith Abu-Raddad and colleagues, estimating the impact on AIDS of malaria infection, and vice versa.
HIV/AIDS control is now receiving enormous attention in global health circles. This is reason both for celebration and concern. It is reason for celebration because the disease has been neglected in the past and the tide may be turning against this humanitarian crisis. It is reason for concern because there is growing evidence that the extensive focus on this one disease is crowding-out resources and policy-maker attention for the many other causes of death and illness of the poor in the developing world.
At its latest meeting, the GAVI Alliance board committed $200 million to support the introduction of new vaccines against rotavirus and pneumococcal disease in developing countries; the Washington Post subsequently ran an editorial in support of the decision.
*This post is co-authored by Ruth Levine
In the Washington Post today, three doctors with sterling reputations in the AIDS world (Lola Daré, executive secretary of the African Council for Sustainable Health Development International and a member of CGD's working group on IMF programs and health spending; Paul Farmer, pioneer of new AIDS treatment programs in Haiti and Rwanda; and chief of Harvard Medical School's Department of Social Medicine Jim Kim, a member of CGD's working group on the Global Fund), call on the Bush Administration to spend $8 billion on training of community workers, nurses and doctors in Africa to deal with AIDS treatment.
Their proposition that many more community-level health workers be deployed to provide essential services, breaking the implicit and costly monopoly of health "professionals" on health delivery, makes eminent sense. But more money for training, without complementary institutional changes that fundamentally alter the incentives for workers at all levels, won't get the outcomes sought by those who are working on AIDS, or any other health challenges.