CGD Policy Blogs
In no particular order, a suggested list of things to do—and things not to do.
The Family Planning 2020 (FP2020) initiative hit its midpoint this year, about four years after its launch by global health leaders in 2012. Set up to “expand access to family planning information, services, and supplies to an additional 120 million women and girls in 69 of the world’s poorest countries by 2020,” the initiative has faced the usual cat herding challenges that go along with its expansive mandate to recruit new funding commitments, track actual spending, coordinate donors and country actions, report on trends in contraceptive prevalence and other FP2020 goals, serve as a clearinghouse for data and knowledge, work with countries to do better planning, and serve as a global voice and advocate.
Now the Government of India and the World Bank have adopted an approach using principles we describe as Cash on Delivery (COD). The program follows three of these principles by linking payments to outcomes, not inputs; independently verifying outcomes; and allowing recipients to take the lead. India has become the single largest payer for outcomes in a nationwide sanitation initiative.
From the superbug scare in Pennsylvania last month to the UK’s recently released Review on Antimicrobial Resistance, slowing the rate at which infections become resistant to antibiotics is rising up the list of global health priorities—and rightfully so. The Review estimates that deaths from antimicrobial resistance (AMR) could reach 10 million people a year by 2050 if we don’t reduce the overuse and misuse of antimicrobials, including antibiotics, and that the economic damage could add up to a staggering $100 trillion by 2050.
The Indian government has sent a clear message with its latest budget: it is now up to the states to take leadership on health and invest more from their own coffers.
India matters for global health. It accounts not only for about one-fifth of the global population, but also one-fifth of the global disease burden. Yet the Indian government spends only 1 percent of its GDP on public health—a paltry amount compared to what other large, federal countries like Brazil and China allocate (4.7 percent and 3.1 percent, respectively). This has a direct impact on Indian citizens who pay more out-of-pocket for health care than citizens in any other G20 country.
2015 has been the year we have been reminded that there have been major gains in development in many parts of the world, but that hundreds of millions of people still suffer the dangerous consequences of poverty, including high levels of maternal and infant mortality, hunger, illness caused by lack of basic sanitation, and death from easily treatable diseases. How can we improve health systems to make them more effective, as well as less wasteful and more accountable?
Imagine a world in which children in Zambia, Bolivia, and Laos have the same chance to survive, grow, and thrive as their peers in Canada or Europe. Such a world sounds nice, to be sure, but probably quite far out of reach. Yet according to the Lancet Commission on Investing in Health, that “grand convergence” between poor and rich countries is achievable within our lifetimes. This is a remarkable and unique opportunity, one unprecedented in human history.
No one said creating development impact bonds (DIB) was going to be easy, but that hasn’t stopped the development community from trying to get them off the ground. The Fred Hollows Foundation, based in Australia, has been hard at work on a DIB to address cataract blindness in Africa. As the Foundation attracts partners to help fund and implement a pilot of the cataract bond, Dr. Lachlan McDonald, the Foundation’s senior health economist, and Alex Rankin, their Global Lead for Policy, Advocacy & Research, shared some lessons learned so far. With Lachlan and Alex’s permission, we’re turning some of those lessons over to you – we hope they’re useful to others seeking to move ahead with their own DIB.