Amanda Glassman


Study finds ‘free’ health care DOES improve health outcomes | 

A sign outside a Ghana health clinic urging people seek care early.
A sign outside a Ghana health clinic urging people seek care early.

Experts in the fight against poverty, like anyone, can sometimes miss the forest for the trees.

That may be happening in the increasingly heated debate swirling around the global movement for Universal Health Coverage. The gist of this global push, led by folks at the World Bank, Rockefeller Foundation and others, is to ensure everyone around the world has access to basic and preventative health services.

Now, people disagree on what is precisely meant by the term ‘universal health coverage,’ aka UHC, but the assumption is that increasing access to essential health care will improve health outcomes and also economic stability – especially for the poor.

Sounds like a good assumption, eh? Not so fast.

Experts in health policy, aid and development say there is insufficient evidence to support the claim that simply increasing access to services improves health outcomes. Which services are we talking about? What outcomes are the best measures? What do we mean by access? Experts say we need to better define terms and test assumptions before taking steps to improve access to health. Continue reading

What global health needs is more (value for) money | 

There’s been a lot of hoo-hah this week in and around the UN General Assembly meeting in New York City focused on maintaining the world’s progress against poverty, especially diseases of poverty – aka global health.

GlobalFundLogoNothing perhaps inspires more hoo-hah in the global health arena than the Global Fund to Fight AIDS, Tuberculosis and Malaria – and for good reason. The Global Fund has saved millions of lives by getting life-saving drugs to people with HIV, TB and malaria, by getting tens of millions of bed nets out to prevent malaria and by literally bringing back to life many of the poorest, most ravaged communities on Earth. It now pays for most TB and malaria care worldwide, and one-fifth of the world’s response to HIV-AIDS.

It’s easy to forget how hopeless we all felt little more than a decade ago regarding the deadly threat of these major killers. It’s easy to forget how crazy ambitious it was to launch the Global Fund. AIDS was burning a wide swath through Africa, which the Economist magazine notoriously dubbed “The Hopeless Continent.” Hardly anyone even thought much about the millions dying from TB and malaria.

The Global Fund was, and is, one of the most hopeful, compassionate and impressive things the international community has done in a long time. That’s why it’s being celebrated in and around the grand UN confab this week. That’s why everyone cheered at the stunning statistics of lives saved, as well as when Britain announced this week it would give another $1.6 billion to the Global Fund, and it’s also why some are clamoring for even more funds – since many millions more are still not reached.

But like most things we humans do when we rush in to fix something, the Global Fund was also seriously flawed.

And it’s high time we deal with the flaws. Or so says Amanda Glassman, a global health expert and author of a new report called More Health for the Money. Here’s the video version:

What? There are 200 different kind of bed nets to prevent malaria? How can that be? Continue reading

Global health spending is stable, non-communicable diseases neglected | 

Some of the world’s leading global health number-crunchers, at the Seattle-based Institute for Health Metrics and Evaluation, wanted to know if a perceived slowdown in what had been a rapidly increasing war chest for fighting diseases of poverty represented The End of the Global Age for global health.

Funding has flattened out, the study reports, but on a plateau that reveals one category of huge neglect – non-communicable diseases.

“From the late 1990s to 2010, we saw a period of rapidly increasing funding for global health,” said Michael Hanlon, one of the lead authors of the report released today entitled Financing Global Health 2012: The End of the Golden Age? The IHME report follows up several earlier, similar reports which revealed a plateau, and even a decline between 2010 and 2011, in new funding for global health activities.

Mike Hanlon IHME“I think the good news here is that we’re not seeing a decline yet and are maintaining a high level of funding,” Hanlon said. “That could change, of course, but I think it’s fair to say we’ve ended the phase of rapid increases in funding and entered a new phase, a maintenance phase.”

Here’s an illustration from the IHME report showing, over the past 10 years or so, the overall increase in development assistance for health (DAH).

IHME Global Health FinancingSo it’s mostly good news, at least for those who believe spending on global health is good.

Whether this is good enough (relative to what we spend on dog food, cosmetics and bottled water – not to mention military adventures or bailing out struggling bankers) is another question, of course. And whether the money is going where it’s most needed is another question raised by this report. Following are some highlights: Continue reading

Stop saying silly things like Dr. Jim Kim is ‘anti-growth’ | 


Dr. Jim Kim

President Barack Obama’s nomination of renowned physician activist Dr. Jim Kim to become head of the World Bank is controversial – apparently because he’s both a physician and an outspoken advocate for a particular approach to fighting poverty.

This has led all sorts of development experts — most of them economists — to give at best faint praise to Kim as a “good person” but then go on to damn him for not having the right kind of knowledge and/or expertise to run this institution devoted to promoting overseas development.

Many of my favorite development (economics) experts like Bill Easterly and Chris Blattman point to a book co-authored by Kim called Dying for Growth, in which he and his colleagues “present evidence that the quest for growth in GDP and corporate profits has in fact worsened the lives of millions of women and men.”

Blattman cites another opponent of Kim’s nomination, Lant Pritchett, who says:

Kim’s views against economic growth and private investment (detailed in his book, Dying for Growth) are already raising eyebrows in the press and causing concern among world leaders.

Oh dear me! The proposed head of the World Bank is “against growth!” Really? Continue reading

Did the week-long World Health Assembly accomplish anything? | 

world health organization logo


World Health Organization

At the close of the week-long meeting of the World Health Assembly, the governing body of the World Health Organization, it’s worth asking what was accomplished in Geneva to advance global health.

The WHO, which is supposed to set priorities and establish guidelines for the international community’s many efforts aimed at improving health or fighting disease, received the most attention for delaying a decision on whether or not to recommend finally destroying all remaining samples of smallpox virus.

As the Associated Press reported:

After two days of heated debate, the 193-nation World Health Assembly agreed by consensus to a compromise that calls for another review in 2014.

It’s a debate that’s been going on since 1986, following the 1980 eradication of this deadly and terrifying disease. The U.S. and Russia, which hold the remaining known smallpox stockpiles, opposed destruction in favor of continuing research. Most other countries wanted the scourge totally removed from the planet. Continue reading