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With shifting disease burdens, growing uncertainties about the future of development assistance for health, and rising demands for more expensive and complex healthcare comes the need for a greater focus on value for money. International health funders and agencies want to know how to make resources stretch further by focusing on the highest impact interventions among the most affected populations. Whether through more efficient procurement systems and supply chains, results-based financing, or more detailed assessments of the effectiveness of health technology, CGD’s work aims to make health funding go further to save, prolong, and improve more lives.
In 2013, a CGD working group signaled important benefits of development impact bonds, and worked through some of the “how-to” of design and implementation. Yet five years later, only three development impact bonds have launched.
Vaccinate children against measles and mumps or pay for the costs of dialysis treatment for kidney disease patients? Pay for cardiac patients to undergo lifesaving surgery, or channel money toward efforts to prevent cardiovascular disease in the first place? For universal health care (UHC) to become a reality, policymakers looking to make their money go as far as possible must make tough life-or-death choices like these.
As developing nations are increasingly adopting economic evaluation as a means of informing their own investment decisions, new questions emerge. The right answer to the question “which perspective?” is the one tailored to these local specifics. We conclude that there is no one-size-fits-all and that the one who pays must set or have a major say in setting the perspective.