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Begin New Search Topic Health Political Geography Global Focus Content Type Working Paper Publication Year within 10 Years

1. Disease Mix and How Economic Freedom Matters for Health Outcomes

Author:
Vincent Geloso, Kelly Hyde, and Ilia Murtazashvili
Publication Date:
03-2023
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
We investigate the institutional foundations of public health. We argue that a key distinction in analysis of disease is between diseases of commerce (diseases associated with movement of people and with affluence) and diseases of poverty (primarily noncommunicable diseases that depend on wealth and income). We show that the mix of disease – the ratio of communicable diseases and those associated with longevity to diseases of poverty – increases in economically free countries. We argue that increasing burdens of diseases of commerce reflects the quality of institutions, as those diseases are better than living shorter, brutish lives where diseases of poverty claim many lives. This analysis also highlights an institutional trade‐​off: economically free institutions reduce certain types of disease while contributing to others.
Topic:
Health, Infectious Diseases, Economy, Institutions, and Public Health
Political Geography:
Global Focus

2. Planetary health: A holistic vision for people and the planet

Author:
Danielle Brady
Publication Date:
09-2023
Content Type:
Working Paper
Institution:
European Policy Centre (EPC)
Abstract:
The nexus between health and the environment has been underscored by crises such as COVID-19 and the climate crisis. As awareness of policy interlinkages grows, so does the need for more coordinated EU and national policymaking. Calls for a more holistic approach have long been recognised, but the pandemic has further emphasised the importance of dismantling existing barriers in policymaking to improve the health status of people, animals, and the planet. This Discussion Paper, funded by Sitra, the Finnish Innovation Fund, advocates for implementing a planetary health approach across all levels of governance to encourage transdisciplinary action and puts forward ten recommendations: Pursue coordinated policymaking by breaking down silos. Appoint an Executive Vice President for the Well-being Economy. Plan and implement national roadmaps and establish common indicators. Create best practices platforms. Adopt planetary health for health systems. Promote education on planetary health. Adopt a European-wide communication campaign. Invest in research and innovation. Foster the integration of the European Health Data Space with future data spaces. Work with international partners to adopt a global planetary health approach. Planetary health offers many benefits for health and the environment. However, without concentrated efforts to move beyond the traditional siloed approach to policymaking, the benefits may never be realised.
Topic:
Climate Change, Health, European Union, and COVID-19
Political Geography:
Global Focus

3. A lockdown a day keeps the doctor away: The effectiveness of non-pharmaceutical interventions during the Covid-19 pandemic

Author:
Anthonin Levelu and Alexander Sandkamp
Publication Date:
05-2022
Content Type:
Working Paper
Institution:
Kiel Institute for the World Economy (IfW)
Abstract:
Countries have employed a variety of non-pharmaceutical interventions (NPIs) in order to curtail the COVID-19 pandemic. However, the success of individual measures in reducing the number of infections remains controversial. This paper exploits a panel data set of 107 countries to estimate the effects of 14 NPIs on the spread of the disease. While almost all measures had a dampening effect on the reproduction rate of the virus, public information campaigns and school closings were most effective, followed by testing policies, contact tracing and international travel restrictions. Public event cancellation and school closings were less effective during the second wave of the pandemic, while public information campaigns and the obligation to wear masks worked better. Several NPIs had a stronger impact on infections in autocratic countries, while others were less effective.
Topic:
Health, Economy, Public Policy, Public Health, and COVID-19
Political Geography:
Global Focus

4. Is Doughnut Economics a Means Towards Achieving Planetary Health?

Author:
Jonathan Ramakrishna
Publication Date:
11-2022
Content Type:
Working Paper
Institution:
Centre for Non-Traditional Security Studies, S. Rajaratnam School of International Studies
Abstract:
With the advent of climate change, the global focus is no longer lingering alone on climate change mitigation and has shifted towards climate adaptation as well. The 2015 Paris Agreement’s target of restricting the average temperature rise in the 21st century to well below two degrees Celsius compared to pre-industrial levels is increasing unlikely, given the inaction of states and the global lack of progress in meeting Paris Agreement goals. As nations scramble to meet Nationally Determined Contributions (NDCs) and effectively design climate policies, the global crisis has given rise to a new domain, Planetary Health. Planetary Health, an interdisciplinary field, is described as a solutions-focused discipline which aims to analyse, mitigate, and resolve human disruption to Earth’s natural systems in the new Anthropocene epoch. The Anthropocene epoch, on the other hand, is established as a geological climate where human activity is drastically altering earth’s systems to an extent that will be reflected in fossil records. Planetary Health inextricably links human health to the health of the planet and illustrates the interdependency of the two, and this relationship has been substantiated by findings which concur that countries with higher ecological threats concurrently experience greater social vulnerability. When climate-induced disasters occur due to human action, there are subsequent consequences on food, water, energy, and human security. The consequences are disproportionately felt by vulnerable communities in states that lack resources and capabilities to address the consequent impacts on human security, and climate instability is a driving force behind political instability. Thus, there is cause for concern not only for the planet’s health but also for human health as the environment’s health continues to dwindle in the Anthropocene Epoch. As such, the concept of Planetary Health is a response to threatened climate security and human security.
Topic:
Economics, Health, International Cooperation, and Strategic Stability
Political Geography:
Global Focus

5. The Next Game Changers: A Priority Innovation Agenda for Global Health

Author:
Cordelia Kenney and Rachel Silverman
Publication Date:
10-2022
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Over the last century, scientific and technological innovation has led to unprecedented improvements in health outcomes—yet research and development (R&D) investments and progress to address health threats has been uneven. Commercial R&D has focused where investors can expect substantial financial returns: rich countries, the diseases that affect them, and high-tech solutions designed for the richest and most sophisticated systems. Despite supplemental funding from philanthropic and government grants, R&D to address many leading causes of death and disability—especially those that primarily affect low- and middle-income countries (LMICs) or insure against future risk—has been consistently underfunded relative to potential health gain. This implies that many untapped opportunities remain to dramatically improve global health and welfare via biomedical innovation. In this paper, we report the results of a horizon-scanning exercise to source opportunities for global health R&D investment—that is, high-value potential biomedical innovations which are currently underfunded but which could be transformative for health, quality of life, and health security in LMICs and around the world. Drawing from a literature review and expert interviews with researchers, economists, funders, advocates, and implementers, we lay out an expansive and high-promise (though non-comprehensive) biomedical innovation agenda for global health spanning the unfinished MDG agenda; non-communicable diseases; and global health security. We conclude with a discussion of implications for research, funding, and practice.
Topic:
Development, Health, Science and Technology, Innovation, and Emerging Technology
Political Geography:
Global Focus

6. Prioritizing Public Spending on Health in Lower-Income Countries: The Role of the Global Financing Facility for Women, Children and Adolescents

Author:
Janeen Madan Keller, Rachel Silverman, Julia Kaufman, and Amanda Glassman
Publication Date:
12-2022
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The Global Financing Facility (GFF), launched in 2015, is a partnership backed by a multi-donor World Bank trust fund that aims to “prioritize and scale-up evidence-driven investments to improve reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N) interventions” in low- and lower middle-income countries. A major component of the GFF’s operational model is centered around the investment case, described by the GFF as “a description of the changes that a country wants to see with regard to reproductive, maternal, newborn, child, and adolescent health (RMNCAH) and a prioritized set of investments required to achieve these results.” Looking retrospectively at investment cases and associated ongoing World Bank operations, this paper aims to shed light on specific aspects of the GFF’s operating model, approach, theory of change, and results to date related to the “development of a costed and prioritized investment case,” and whether the investment case helps to prioritize public spending on health in the real world. The portfolio-wide findings suggest that the GFF delivers a clear value-add within the global health architecture by directing more funding to flow directly through governments via increased World Bank lending for RMNCAH-N (especially in the context of COVID-19-related service disruptions and fiscal contractions). The role of the investment case in aligning and prioritizing resources behind a consensus set of highest-value RMNCAH-N interventions within a specific funding envelope is less well documented in the public domain; GFF efforts to directly influence government RMNCAH-N spending decisions and their efficiency seem to occur primarily through follow-on resource mapping and expenditure tracking. The paper concludes with three recommendations for the GFF and its donors: (1) pursue a deliberate strategy for prioritization of RMNCAH-N services and products within the realistic budget constraint to advance evidence-based decisions on certain trade-offs; (2) increase transparency and public visibility into GFF-supported activities and funding, especially related to RMNCAH-N product procurement and overall resource tracking; and (3) explore incentives for increased donor co-financing within the framework of World Bank projects as a strategy to pool and channel more resources through government coffers.
Topic:
Health, Children, Women, Public Spending, and Gender
Political Geography:
Global Focus

7. COVID-19 in the European Union: health impacts and effects on economic activity

Author:
Leonardo Cadamuro, Scott Marcus, and Francesco Papadia
Publication Date:
07-2022
Content Type:
Working Paper
Institution:
Bruegel
Abstract:
This paper quantitatively describes different aspects of the COVID-19 pandemics: new cases, hospitalisations, intensive-care admissions and deaths, while illustrating their changing relationships over time. It then assesses how the different variables have affected relevant sectoral and macroeconomic indicators. Finally, it concludes that, from an economic perspective, what matters when it comes to managing the pandemic is to prevent intensive-care admissions and deaths arising from COVID-19. The success of vaccination should be measured in terms of its ability to prevent the most serious consequences, rather than its ability to prevent infections and hospitalisations.
Topic:
Health, European Union, Economy, Macroeconomics, and COVID-19
Political Geography:
Global Focus

8. Heroes on Strike: Trends in Global Health Worker Protests During COVID-19

Author:
Sorcha A. Brophy, Veena Sriram, Haotian Zong, Chloei Andres, Maria Paz Mawyin, and Narayanan GL
Publication Date:
04-2022
Content Type:
Working Paper
Institution:
Accountability Research Center (ARC), American University
Abstract:
This Accountability Note describes global trends in health worker protests between March 11, 2020 and March 10, 2021. We argue that the frequent characterization of health workers as heroes of the pandemic obscures the fact that health workers themselves describe the challenges they face during this time as violations of their rights as workers, highlighting the obligations of their employers to provide working conditions and remuneration that justify the risk they assume. Using data from the Armed Conflict Location & Event Data (ACLED) Project, we first provide a global overview of the growth in health worker protest activity in the March 2020–2021 period as compared to the March 2019–2020 period. Health workers engaged in protest activity with greater frequency during the first year of the pandemic than during the prior year. The eighty-five countries included in the ACLED data set in both the March 2019–2020 period and the March 2020–2021 period experienced a sixty-two percent increase in health worker protest activity (from 2416 protests to 3913 protests). We then provide an overview of the content of the 6589 health worker protests in the ACLED dataset between March 2020 and March 2021, describing protests in 149 countries in terms of five categories: working conditions and remuneration, resources, health system delivery issues, public policy, and other. By far, the largest category of protests during this period are those related to working conditions and remuneration. Approximately sixty-six percent (N=4358) of global protests in the 2020–2021 period expressed health worker dissatisfaction about issues such as: occupational hazards, unpaid wages, risk allowances and job security. Surprisingly, personal protective equipment (PPE) concerns—an issue covered frequently in the media—motivated a relatively low percentage of the protests (less than nine percent). We note this not to downplay the gravity of global PPE shortages, but to situate PPE shortages as one among many health worker concerns during the pandemic. Protests initiated by health workers about health system delivery issues provide an important reminder that even in the middle of a pandemic, not everything was about COVID-19. Sixty-two percent of the health system-related protests during the 2020–2021 period were about issues that were not coded as directly related to the COVID-19 pandemic. Similarly, the vast majority of health workers’ protests around public policy were not about pandemic-related government policy, but about social issues like climate change, immigration, police brutality, and elections. The aim of this analysis is to understand what health workers advocated for during a time of immense pressure, and to identify some broad areas of concern for health sector accountability. Through this analysis, we prepare the groundwork for future research and action, and share preliminary guidance regarding how health sector stakeholders—including government, health worker associations, unions, and civil society—might develop improved systems of accountability.
Topic:
Health, Protests, Crisis Management, and COVID-19
Political Geography:
Global Focus

9. Reducing mobility of SARS-CoV-2 variants to safeguard containment

Author:
Martin Hellwig, Viola Priesemann, and Guntram Wolff
Publication Date:
05-2021
Content Type:
Working Paper
Institution:
Bruegel
Abstract:
Escape variants can cause new waves of COVID-19 and put vaccination strategies at risk. To prevent or delay the global spread of these waves, virus mobility needs to be minimised through screening and testing strategies, which should also cover vaccinated people. The costs of these strategies are minimal compared to the costs to health, society and economy from another wave.
Topic:
Health, Governance, Global Political Economy, Vaccine, and COVID-19
Political Geography:
Global Focus

10. Meeting the Global Health Challenge to Reduce Death and Disability from Alcohol, Tobacco, and Sugar-Sweetened Beverage Consumption with Corrective Taxes

Author:
Chris Lane and Vinayak Bhardwaj
Publication Date:
11-2021
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Behind the daily trauma of COVID-19 lies a larger and longer-lasting global health challenge resulting from the consumption of tobacco, alcohol, and sugar-sweetened beverages. Using a sample of 25 large advanced and emerging market economies accounting for three-quarters of global GDP, we show that about 60 million productive life years were lost every year in 2000, 2010, and 2019 from death and disability attributable to alcohol, tobacco, and diets high in sugar-sweetened beverages. Using the cost-of-illness framework, the economic value of these lost productive years in 2019 is approximately $2.1 trillion in our country sample (in 2017 purchasing power parity dollars [PPP$]). We show that over a 20-year period, a higher tax effort is associated with larger reductions in economic costs. We also show that total corrective taxes for all the products under investigation fall far short of the indirect costs of consumption in all countries. We conclude that all advanced economies and emerging markets could reap substantial macroeconomic benefits from better health by raising corrective taxes on alcohol and tobacco and by introducing corrective taxes on sugar-sweetened beverages.
Topic:
Health, Disability, Tax Systems, Health Crisis, and Addiction
Political Geography:
Global Focus

11. A “Hidden Front” in the Battle Against COVID-19: How Behavioral Data is Helping Contain the Pandemic and Improve Policy

Author:
Paul von Chamier and Neil Martin
Publication Date:
11-2021
Content Type:
Working Paper
Institution:
Center on International Cooperation
Abstract:
COVID-19 has provided a sharp reminder of the key role citizens’ perceptions and attitudes play in shaping the outcomes of public policy. This experience is changing the way governments use data to combat the pandemic and set priorities for the recovery.
Topic:
Health, Recovery, Data, and COVID-19
Political Geography:
Global Focus

12. Addressing Antimicrobial Resistance

Author:
Aspen Health Strategy Group
Publication Date:
04-2020
Content Type:
Working Paper
Institution:
Aspen Institute
Abstract:
In June 2019, the Aspen Health Strategy Group met for three days to explore the topic of antimicrobial resistance. We are pleased to present the final report from our work, based upon the group’s rich discussion. In the tradition of the thought-provoking conversations and dialogue on how to address critical societal issues — the hallmark of the Aspen Institute — the report includes five big ideas to address antimicrobial resistance.
Topic:
Health, Public Health, Resistance, and Medicine
Political Geography:
Global Focus

13. Fight the COVID-19 Pandemic and Improve Global Health Governance

Author:
Lin Ren, Aizong Xiong, Guoding Wu, Chen Shen, Xu Tian, and Bo Peng
Publication Date:
07-2020
Content Type:
Working Paper
Abstract:
The fast spreading of the COVID-19 across the globe points to the urgency of strengthening global health governance. As the core global health governance institution, the WHO has taken a series of actions after the eruption of the epidemic and played an important role in providing guidance and coordinating global forces to combat the epidemic. The epidemic, however, has also exposed some defects of the global health governance mechanism, especially the WHO, and posed challenge to it. The international community needs to strengthen its support for the WHO to improve its role in the global health governance.
Topic:
Health, Governance, and COVID-19
Political Geography:
China, Asia, and Global Focus

14. Is the Coronavirus Catalyzing New Civic Collaborations for Open Government?

Author:
Abigail Bellows and Nada Zohdy
Publication Date:
11-2020
Content Type:
Working Paper
Institution:
Carnegie Endowment for International Peace
Abstract:
The pandemic is spurring elite and grassroots civic actors to cooperate more, but the gulf between them remains wide. Civic actors must seize the opportunity for reform on open government issues. From Africa to Latin America to Europe, the coronavirus pandemic has generated a surge in public demand for government transparency and accountability. To seize this window for reform, elite and grassroots civic actors concerned with open governance must overcome the cleavage that has long existed between them. Thus far, the pandemic has catalyzed some new civic collaborations, but not at the scale or depth needed to seize that window. In general, civil society groups report feeling more isolated during the pandemic. In some places, the urgency of tackling open government issues during the pandemic has helped overcome that isolation by deepening partnerships among existing networks. But in other places, those partnerships have yet to take shape, and new alliances are less likely to form without the benefit of face-to-face interactions. Even the partnerships that have crystallized or deepened do not appear to be changing the fundamental roles of elite and grassroots civic actors. It is possible that this shift may happen over time. Or it may be that the pandemic alone is not enough to dislodge structural barriers to deeper cooperation. The pandemic has dramatically changed the operations of elite and grassroots actors alike. The impact of those changes on collaboration between the two depends on preexisting levels of technological capacity. In places with limited connectivity, the pandemic has exacerbated the digital divide, adversely affecting grassroots actors. Meanwhile, in places with good connectivity, technology is enabling broader (though shallower) participation, laying the groundwork for more elite-grassroots collaboration. Although many civil society groups are struggling financially during the pandemic, those effects are mitigated to some degree by continuing donor interest in the open government sector. This is encouraging, as coalition building requires dedicated, flexible resources. Finally, it is a more dangerous time to be working on open government issues in general, and grassroots actors bear disproportionate risks in doing so. This underscores the need for more vertical alliances to mitigate civic space threats.
Topic:
Civil Society, Government, Health, Pandemic, and COVID-19
Political Geography:
Global Focus

15. Corona Politics: The cost of mismanaging pandemics

Author:
Helios Herrera, Maximilian Konradt, Guillermo Ordoñez, and Christoph Trebesch
Publication Date:
09-2020
Content Type:
Working Paper
Institution:
Kiel Institute for the World Economy (IfW)
Abstract:
The Covid-19 pandemic is a major test for governments around the world. We study the political consequences of (mis-)managing the Covid crisis by constructing a highfrequency dataset of government approval for 35 countries. In the first weeks after the outbreak, approval rates for incumbents increase strongly, consistent with a global “rally around the flag” effect. Approval, however, drops again in countries where Covid cases continue to grow. This is especially true for governments that do not implement stringent policies to control the number of infections. Overall, the evidence suggests that loose pandemic policies are politically costly. Governments that placed more weight on health rather than short-term economic outcomes obtained higher approval.
Topic:
Government, Health, International Political Economy, Health Care Policy, Pandemic, and COVID-19
Political Geography:
Global Focus

16. Overconfidence and Hygiene Non-compliance in Hospitals

Author:
Katharina Lima de Miranda, Lena Detlefsen, and Michael Stolpe
Publication Date:
07-2020
Content Type:
Working Paper
Institution:
Kiel Institute for the World Economy (IfW)
Abstract:
Among measures to fight hospital acquired infections, an emerging epidemic in many countries around the world, adoption of appropriate hand hygiene practices by healthcare workers is considered a priority. Despite their simplicity and effectiveness, healthcare workers’ compliance is poor, with most empirical studies finding compliance rates well below 50% in many countries. Management strategies to increase compliance are often based on the notion that non-compliance is a moral hazard problem, characterized by asymmetric information between hospital management and healthcare workers. In this study, we provide empirical evidence that an individual behavioral characteristic, known as overconfidence, induces many healthcare workers to overestimate their hand hygiene compliance and hence to underperform unknowingly and unintentionally.
Topic:
Health, International Political Economy, Health Care Policy, and Hospitals
Political Geography:
Global Focus

17. Health Is a Political Choice.

Author:
Tricontinental: Institute for Social Research
Publication Date:
06-2020
Content Type:
Working Paper
Institution:
Tricontinental: Institute for Social Research
Abstract:
In dossier no. 29, we argue against the return to normal – specifically in the healthcare systems of the bourgeois order. In part 1, we go over what the pandemic has shown us about the healthcare system; in part 2, we attend to the voices of leaders of healthcare workers; and in Part 3, we lay out an agenda for a new healthcare compact based on the demands of healthcare workers, their unions, and their movements.
Topic:
Health, Politics, Governance, and Leadership
Political Geography:
Global Focus

18. Understanding the Opportunity Cost, Seizing the Opportunity: Report of the Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines

Author:
The Working Group on Incorporating Economics and Modeling in Global Health Goals and Guidelines
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Internationally set goals and guidelines directly influ­ence the setting of health care priorities at the national level, affecting how limited resources are generated and allocated across health care needs. The influence of global priority setting, such as through the formu­lation of overarching goals or normative guidelines for specific disease areas, is particularly significant in low- and middle-income countries that rely heavily on overseas development assistance. Because no sys­tematic approach exists for dealing with resource con­straints, however, which vary across countries, goals and guidance are often inappropriate for some country contexts; their implementation can, therefore, reduce the efficiency and equity of health care spending. The Working Group on Incorporating Economics and Modelling in Global Health Goals and Guidelines, co-convened by the Center for Global Development, Thanzi la Onse, and the HIV Modelling Consortium, has brought together disease specialists, policymakers, economists, and modelers from national governments, international organizations, and academic institutions across the globe to address these issues, to take stock of current approaches, and make recommendations for better practice. The Working Group deliberated on the roles and purposes of goals and guidelines and consid­ered how economic evidence might be formally incor­porated into policy recommendations and health care decision making. The target audiences for this report are international health institutions, large stakehold­ers in disease programs across the world, and national governments.
Topic:
Development, Health, Health Care Policy, and Public Health
Political Geography:
Global Focus

19. Imagining the Alternative Worlds of 2030: Policy Implications for the Future of Global Health Procurement

Author:
Janeen Madam Keller and William Savedoff
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The availability and affordability of health products—medicines, diagnostics, devices, and equipment—are critical to achieving universal health coverage and improving health outcomes. Yet low- and middle-income countries face multiple challenges in procuring health products related to institutional inefficiencies, market failure, and fragmented demand. At the same time, the world is evolving rapidly in ways that will affect health procurement, from changes in countries’ eligibility for foreign assistance to advances in information technologies. Looking forward, efforts to improve global health procurement must proactively address the sweeping changes on the horizon. Drawing on a range of political, economic, and social trends, this paper envisions how the global landscape might change between now and 2030, with a focus on the implications for global health, particularly the procurement of health products. The paper develops three possible but distinct futures—worlds characterized as atomistic, privately led, or multilateral.It concludes by describing the policy options and locus of action to improve global health procurement in light of these scenarios, emphasizing three areas of work: financing and modes of collaboration, procurement procedures and tools, and procurement capacity.
Topic:
Health, Health Care Policy, Public Health, and Health Crisis
Political Geography:
Global Focus

20. Tackling the Triple Transition in Global Health Procurement

Author:
Rachel Silverman, Amanda Glassman, Kalipso Chalkidou, and Janeen Madan Keller
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive.
Topic:
Health, Public Health, Pandemic, Procurement, and Medicine
Political Geography:
Global Focus

21. Vaccine Introduction and Coverage in Gavi-Supported Countries 2015-2018: Implications for Gavi 5.0

Author:
Roxanne Oroxom and Amanda Glassman
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
With a vision of “creating equal access to new and underused vaccines,” Gavi set several coverage-specific targets for 2020 as part of its Phase IV strategy, including the immunization of an additional 300 million children, increased pentavalent 3 and measles-containing vaccine (MCV) 1 coverage, and greater equity in coverage across wealth quintiles.[1] The strategy also called for broadening protection through improved routine coverage and the introduction of new vaccines.[2]
Topic:
Health, Children, Public Health, and Vaccine
Political Geography:
Global Focus

22. Global Immunization and Gavi: Five Priorities for the Next Five Years

Author:
Amanda Glassman, Cordelia Kenney, and Janeen Madan Keller
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Child vaccination remains among the most cost-effective uses of public and aid monies.[1] In a highly contested funding environment where priorities must be set for the allocation of scarce concessional resources, investment in expanding the availability and coverage of cost-effective vaccination must come at the top of the list. Gavi’s mission—saving children’s lives and protecting people’s health by increasing equitable use of vaccines—remains highly relevant. Gavi and its partners have made enormous progress towards increasing equity in the introduction of vaccines; children living in the lowest-income countries now have access to the same set of vaccines as those living in high-income countries. Gavi and partners have also contributed to increased coverage; immunization rates are higher in Burundi and Rwanda, for example, than in many places in the United States and Europe. Yet the effects of under-immunization anywhere can have global implications everywhere, as recent outbreaks illustrate. New or dormant threats are also a new reality—newly vaccine-preventable diseases like Ebola or virulent flu strains can spread swiftly and lethally in an interconnected world.
Topic:
Health, Public Health, Vaccine, and Immunization
Political Geography:
Global Focus

23. Tackling the Triple Transition in Global Health Procurement

Author:
Rachel Silverman, Janeen Madan Keller, Amanda Glassman, and Kalipso Chalkidou
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive. Access to medicines, diagnostics, devices, and equipment is driven in large part by the efficiency of their procurement. Procurement is, therefore, central to the efforts of low- and middle-income countries to improve health, meet the Sustainable Development Goals, and achieve universal health coverage. Health product purchasing in low- and lower-middle-income countries already makes up a sizeable share of overall health spending; in fact, in just a subset of these countries, spending on health products totals an estimated $50 billion per year.[1] Procurement is not only essential to the missions of global health entities like the Global Fund, Gavi, UNICEF, UNFPA, and PEPFAR, but it also represents big money. In the case of the Global Fund, health product procurement accounts for $2 billion per year,[2] or almost half of its 2017 disbursements.[3] Yet despite its importance, procurement is an underappreciated health system function. Today’s procurement systems are hobbled by inefficiencies that leave some of the poorest countries paying some of the highest drug prices in the world.
Topic:
Health, Public Health, Transition, and Procurement
Political Geography:
Global Focus

24. Digital Democracy

Author:
Brian Budd, Nicole Goodman, Sarah Shoker, Dominik Stecula, Sara Bannerman, Tony Porter, Netina Tan, Chelsea Gabel, Liam Midzain-Gobin, Devin Ouellette, Norwin Tabassum, Catherine Frost, Marcel Goguen, Brian Detlor, Amelia Joseph, Andrea Zeffiro, and Angela Orasch
Publication Date:
10-2019
Content Type:
Working Paper
Institution:
Institute on Globalization and the Human Condition, McMaster University
Abstract:
As we approach the third decade of the 21st century, there are numerous disturbing signs that two world-historical accomplishments that had seemed so promising are in serious trouble. The first of these is digital networks, which had promised to bring the world closer together, bringing broader popular participation and engagement and new ways of generating wealth and wellness. However, today anxieties about digital networking are proliferating, sparked by growing levels of digital surveillance, the effects of digital devices on our mental health and sociality, and the loss of jobs to artificial intelligence. The second troubled historical accomplishment is democracy, which at the end of the Cold War seemed to be expanding inexorably, but which now is challenged by growing authoritarianism and popular discontent with democratic governments. Freedom House’s 2019 report, entitled “Democracy in Retreat”, documents the 13th consecutive year of weakening democratic norms around the world (2019). These two global developments are related, due to the negative impact of “fake news” spread digitally on elections or the disruptive effects of digitization on the type of social cohesion that should be an important precondition for and effect of democracy. However, the relationships between digitization and democracy are multidimensional and complex, and much work remains to identify and analyze them. This working paper contributes to addressing this need by bringing together a set of interdisciplinary contributions, exploring different facets of the relationship between digitization and democracy in a variety of settings, from the local through to the global. This introduction to the working paper provides an overview of some key issues and literatures relevant to the relationship between digitization and democracy, including the historical shift in assessments of this relationship from optimism to concern; analysis of more specific ways that digitization and democracy interact; and the increasingly global aspects of the problem and the challenges this poses to governance. The final section of this introduction provides a summary of the individual contributions that follow. These short papers were presented at a workshop at McMaster University in September 2018 and then revised for this set of working papers to bring out their common themes more consistently. This final section of the introduction emphasizes the inter-relatedness of digitization and democracy in various settings. This type of global and multidimensional mapping of the problem is crucial if these problems, and the fears about our global futures that accompany them, can be diagnosed, treated, and overcome.
Topic:
Health, Democracy, Media, Surveillance, and Digitization
Political Geography:
Global Focus

25. Development Impact Bonds Targeting Health Outcomes

Author:
Lorcan Clarke, Kalipso Chalkidou, and Cassandra Nemzoff
Publication Date:
12-2018
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
As of December 2018, seven development impact bonds (DIBs) have been launched across seven countries with nearly US$55million in cumulative outcome funding. DIBs fund public services through contracts where private investors provide upfront flexible funding to service providers and outcome funders repay these investors based on the outcomes achieved by people receiving services. Three DIBs specifically target health outcomes: the Humanitarian Impact Bond, the Utkrisht Impact Bond, and the Cameroon Cataract Bond. The three “health DIBs” involve US$26.5 million in upfront investment, US$38.1 million in outcome funding and aim to impact the health of at least 31,600 people. 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. Building on a scoping review of relevant literature, we outline health DIBs in the pipeline and note that the potential of DIBs as a funding structure is hindered by the lack of publicly available information on their estimated impact and value for money. We offer three recommendations to improve evaluation and inform development of DIBs in the future: (1) publish plans and evaluations, (2) create and use consistent reporting guidelines, and (3) allocate funding to evaluate impact and value for money.
Topic:
Development, Health, and Humanitarian Intervention
Political Geography:
Global Focus

26. How Individuals’ Birth Weight and Later Risk Factors Interact to Determine Their Risk of Cardiovascular Disease: A Longitudinal Study in the Philippines

Author:
Marjorie Pajaron
Publication Date:
12-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Cardiovascular diseases (CVDs), which are disorders of the heart and blood vessels, are the world’s leading cause of death (WHO, 2016). The transition from infectious diseases to non-communicable diseases (NCDs), primarily CVDs, as the primary cause of mortality and morbidity worldwide— combined with the economic burden associated with heart-related diseases—prompted the World Health Organization (WHO) and its regional offices to identify CVDs’ risk factors (WHO, 2016). This paper examines these risk factors with a focus on the fetal environment and its interaction with adult body mass index (BMI), using longitudinal data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS). Using a Cox proportional hazards model to estimate hazard ratios adjusted for age and risk factors in adulthood, such as cigarette smoking, the results suggest that there is a positive association between birth weight and heart disease. In addition, when birth weight is interacted with BMI, raised blood pressure is found to be higher among those who were bigger infants at birth and grew to be lighter adults, suggesting centile crossing. Probit models are also used for sensitivity analysis, and the results are consistent with those of the hazards model. Other factors such as adult obesity and a smoking habit are also positively associated with hypertension and CVD.
Topic:
Health, Medicine, Risk Factors, and Birthing
Political Geography:
Global Focus

27. Enhancing Public Health Outcomes in Developing Countries: From Good Policies and Best Practices to Better Implementation

Author:
Michael Woolcock
Publication Date:
02-2018
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
In rich and poor countries alike, a core challenge is building the state’s capability for policy implementation. Delivering high-quality public health and health care – affordably, reliably, at scale, for all – exemplifies this challenge, since doing so requires deftly integrating refined technical skills (surgery), broad logistics management (supply chains, facilities maintenance), adaptive problem solving (curative care) and resolving ideological differences (who pays? who provides?), even as the prevailing health problems themselves only become more diverse, complex and expensive as countries become more prosperous. The current state of state capability in developing countries, however, is demonstrably alarming, with the strains and demands only likely to intensify in the coming decades. Prevailing ‘best practice’ strategies for building implementation capability – copying and scaling putative successes from abroad – are too often part of the problem, while individual training (‘capacity building’) and technological upgrades (e.g., new management information systems) remain necessary but deeply insufficient. An alternative approach is outlined, one centered on building implementation capability by working iteratively to solve problems nominated and prioritized by local actors.
Topic:
Health, Developing World, State, Public Policy, and Policy Implementation
Political Geography:
Global Focus

28. The Impact of Mental Health and Psychosocial Support Interventions on People Affected by Humanitarian Emergencies: A systematic review

Author:
Anna Chiumento, Kelly Dickson, Lambert Felix, and Bangpan Mukdarut
Publication Date:
03-2017
Content Type:
Working Paper
Institution:
Oxfam Publishing
Abstract:
This systematic review, commissioned by the Humanitarian Evidence Programme and carried out by a team from the EPPI-Centre, University College London (UCL), draws together primary research on mental health and psychosocial support (MHPSS) programmes for people affected by humanitarian crises in low- and middle-income countries (LMICs). It investigates both the process of implementing MHPSS programmes and their receipt by affected populations, as well as assessing their intended and unintended effects. What are the barriers to, and facilitators of, implementing and receiving MHPSS interventions delivered to populations affected by humanitarian emergencies? What are the effects of MHPSS interventions delivered to populations affected by humanitarian emergencies? What are the key features of effective MHPSS interventions and how can they be successfully developed and implemented? What are the gaps in research evidence for supporting delivery and achieving the intended outcomes of MHPSS interventions? The systematic review, together with corresponding executive summary and evidence brief, forms part of a series of humanitarian evidence syntheses and systematic reviews commissioned by the Humanitarian Evidence Programme. Other reports in the series review the evidence on interventions or approaches to mental health, child protection, market support and household food security, acute malnutrition, pastoralist livelihoods, shelter self-recovery and urban response.
Topic:
Health, Children, Mental Health, and Humanitarian Crisis
Political Geography:
Global Focus

29. The Pillars of Governance. A Macro-Quantitative Analysis of Governance Performance

Author:
Gregor Walter-Drop, John Wiesel, and Melissa Lee
Publication Date:
05-2016
Content Type:
Working Paper
Institution:
Collaborative Research Center (SFB) 700
Abstract:
State building is seen as the central tenet of many present-day development efforts. This rests on a global normative script that emphasizes the modern state’s role in providing governance services from security to education to health. However, the relationship between statehood and governance outcomes is not well understood. We use a macro-quantitative approach to analyze state performance in various governance dimensions including security, health, education, economic subsistence, infrastructure, and the environment. We test for the power of statehood in explaining the variation in governance outcomes while controlling for various other factors prominent in the respective debates in political science, economics, and development studies. The analysis yields three interesting results. First, statehood does not have a consistent significant relationship with governance outcomes. It matters more for some outcomes than for others. Second, we find that statehood sometimes performs better at predicting subjective (survey-based) evaluations than at predicting objective measures of governance outcomes (which confirms the ubiquity of the normative script). Finally, we find that the degree of domestic female empowerment performs consistently strong at explaining the variation in governance outcomes. This result is consistent with the policy community’s emphasis on women’s roles in development.
Topic:
Security, Education, Health, Infrastructure, Governance, and State Building
Political Geography:
Global Focus

30. Contagion Exposure and Protection Technology

Author:
Deigo Cerdeiro
Publication Date:
05-2015
Content Type:
Working Paper
Institution:
Institute for New Economic Thinking (INET)
Abstract:
People adopt diverse measures to protect from contagion. I propose a taxonomy of protection technologies, and present a model to study the implications of the technology on the prevalence of infections and on welfare at different levels of exposure. People adopt diverse measures to protect from contagion. I propose a taxonomy of protection technologies, and present a model to study the implications of the technology on the prevalence of infections and on welfare at different levels of exposure. I find that the effect of aggregate exposure on prevalence and on protection inefficiencies depends crucially on the characteristics of the available protection technology. For example, under certain conditions the existence of a vaccine will lead to lower infection rates and smaller welfare costs of decentralization as the society becomes denser. I discuss the implications for disease eradication, the equilibrium consequences of antigenic drift, the desirability of interventions in the absence of universal vaccines, and coordination failures in protection.
Topic:
Health, Science and Technology, Infectious Diseases, and Medicine
Political Geography:
Global Focus

31. Alternatives to High-Risk Radiological Sources

Author:
Miles A. Pomper, Egle Murauskaite, and Tom Coppen
Publication Date:
03-2014
Content Type:
Working Paper
Institution:
James Martin Center for Nonproliferation Studies
Abstract:
There is growing global awareness of the need to secure radiological sources in order to prevent terrorists from using such materials in a radiological weapon, such as a “dirty bomb.” A new CNS report calls for a move towards permanently reducing this threat by substituting non-isotopic alternatives for these sources in civil uses. As an initial step, the authors propose a move towards gradual phase-out of cesium chloride use in pre-transfusion blood irradiation on a global scale – a domain where non-isotopic alternatives are considered to be the most viable in the short-term. They urge United States to launch an international initiative involving the phase out of cesium-chloride and other high-risk radiological sources as a “gift basket” for the upcoming 2014 Nuclear Security Summit. Cesium chloride is one of the most commonly used radiological materials, despite being an IAEA Category 1 “extremely dangerous” source. Because cesium chloride is easily dispersible, water soluble, and relatively easy to handle, it is particularly suitable for terrorist purposes. The blood irradiators that use it as a source are located in many large hospitals and blood banks (inherently publicly accessible spaces), and the source is usually transported through regular civilian infrastructure at the beginning and the end of its lifecycle, giving more cause for concern. Cesium chloride based irradiators are used to treat blood and blood products prior to transfusion in order to prevent a rare but fatal Graft Versus Host Disease (GVHD). A growing number of non-isotopic alternatives are becoming available for that purpose, but there is a serious lack of awareness about the range of options and how they compare to current practices, both among the medical professionals and national regulators.
Topic:
Health, Biological Weapons, Radiological Weapons, and Medicine
Political Geography:
Global Focus