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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.
Using publicly available information, we describe all seven DIBs, and evaluate the three “health DIBs” in more detail, comparing their stakeholders, implementation, and outcome structures. We offer three recommendations to improve evaluation and inform development of DIBs in the future.
Rwanda’s performance-based incentives were effective for some indicators, but unconditional financing also induced improvements. The incentive effects persisted in the medium-run and as the program was scaled-up.
Counting the number of patients on treatment is no longer enough. For years even the friendliest critics of the global struggle against AIDS have pointed out that this metric unfairly neglects the people who are not put on treatment and then die, largely because their deaths are uncounted except in so far as they increase the treatment “coverage rate.” This diverts attention from the challenge of assuring that patients are retained on treatment and remain alive and healthy, rather than failing treatment and dying, sometimes after only a few months.
The global commitment to universal health coverage—target 3.8 of the Global Goals for Sustainable Development—is as ambitious as it is energizing. Ensuring everyone, everywhere around the world has access to quality health care without being forced into poverty will require stronger health systems that generate better patient services and improve people’s health. And, to that end, investments in hospitals and their performance will be key.
Ten years ago – on May 27, 2003 – the President’s Emergency Plan for AIDS Relief was born with the stroke of a pen by President George W. Bush. Over the last decade, the program has experienced tremendous growth and made inroads against HIV/AIDS, TB and malaria in some of the world’s hardest hit areas. And through it all, PEPFAR managed to maintain bi-partisan support that bridged two US Administrations, six US congressional sessions, and one global economic crisis.
Many health improving interventions in low-income countries are extremely good value for money. So why has it often proven difficult to obtain political backing for highly cost-effective interventions such as vaccinations, treatments against diarrhoeal disease in children, and preventive policies such as improved access to clean water, or policies curtailing tobacco consumption?