Dear Colleagues,

WHO has announced that the next World Health Report — to be published in September 2013 — will focus on research for UHC. As for the provisional agenda of the World Health Assembly, see  here.

We now have less than 1,000 days until the end of the MDGs. International discussions are underway to determine the post-2015 development agenda. Just this week, the final  report of the Thematic Consultation on Health in the post 2015 development agenda was published. We also celebrate the  World Health Worker week (8-12 April) this week, in case you didn’t know, and the G8 declared rape a war crime at a summit in London, which was about time.

 In this newsletter we pay quite some attention to the Global Fund (with its new target for 2014-2016 and some information on the pre-replenishment conference in Brussels), the Lancet series on childhood pneumonia and diarrhoea (as well as the new WHO/UNICEF Global Action plan to address these two diseases), Lancet letters on Option B+ and Obama’s FY14 budget request. And much more…

 In this week’s guest editorial, Juliet Nabyonga from Uganda provides some key messages from her recent paper (in International Archives of Medicine) on government funding for health trends between 2000 and 2009 for WHO African Region countries.


Enjoy your reading.

Kristof Decoster, Ildikó Bokros, Peter Delobelle, Basile Keugoung & Wim Van Damme




Status and future prospects of government funding for health for WHO African Region countries


By Juliet Nabyonga Orem (WHO, Uganda office and lecturer at Makerere University School of Public Health)

The importance of government funding for health services has been emphasized for a number of reasons. Government health funding is typically more predictable and flexible than donor funding. It is also a demonstration of government’s commitment to invest in its citizens’ health. The underinvestment in health against a backdrop of slow progress towards the MDGs has been a concern for African governments since the beginning of this century.  Commitments were made in Abuja in 2001 and in several health financing panels for Ministers of Health and Ministers of Finance in Kampala (July 2010), Addis Ababa (March 2011) and Yamoussoukro (September 2011), all in an effort to explore ways of increasing government investment in health. In a recent paper, we analyzed National Health Account data compiled by WHO for the 46 countries in the WHO African Region, to understand the health financing changes that have occurred in these countries over a period of 10 years (2000 to 2009).

Read the rest here

Global Fund


1.    GFO – Global Fund Sets Ambitious Fundraising Target of $15 Billion

David Garmaise;

Earlier this week, Aidspan published Issue 214 of its Global Fund Observer. The issue is devoted to the 2014-2016 replenishment of the Global Fund and to coverage of the various documents published by the Fund for its pre-replenishment meeting in Brussels (9-10 April 2013). For some more info on the fourth replenishment (including the agenda of meeting in Brussels and some accompanying reports ), see also this page on the GF website. The Global Fund Fourth Replenishment is the name given to the organization’s work to secure financing for 2014-2016. A Preparatory Meeting was held in Brussels this week, which served as an opportunity for the organization to present to current and potential donors the results of its programs and its financing needs for the next three years. It will close with a pledging meeting to be held in the fourth quarter of 2013.

The target is clear, as mentioned also by the new boss, Mark Dybul: the Global Fund wants to raise $15 billion for 2014–2016. The Fund announced the target in a news release issued on the eve of the pre-replenishment meeting in Brussels. The $15 billion target is an increase of almost 50% over what was pledged for 2011–2013.

For some coverage in the Guardian on this news, see this  article, ‘Difficult times in the global fight against the three diseases’. A report released on Monday by the Global Fund said it needed $87bn until 2016 to finance programmes in 151 nations. Of that, $58bn is targeted for Aids/HIV, $15bn for tuberculosis and $14bn for malaria.

2.    KFF – Global Fund Concludes 2-Day Conference In Brussels

This short KFF article gives a brief overview of the two-day conference in Brussels where the GF tried to make the case for the 15 billion. Mark Dybul ended the conference with a passionate appeal inviting everyone “to join the effort, to do everything possible to reach new funding goals, because the stakes are so high and the opportunity so rare. …If we don’t seize this moment, we will be dealing with these diseases for generations.”


Lancet series on childhood pneumonia & diarrhoea


This week’s Lancet  Series on Childhood Pneumonia and Diarrhoea was led by Aga Khan University, Pakistan, and provides evidence for integrated control efforts for childhood pneumonia and diarrhoea. Papers in the Series examine the global burden of these two illnesses, cost-effective interventions, and report on the global and country-level remedies needed to eliminate preventable deaths from pneumonia and diarrhoea by 2025.

3.    Lancet (Comment) – Continuing the child survival revival

Udani Samarasekera & Richard Horton;

This Comment introduces the series and makes the case for integrated action.

There is much to celebrate in child health. Over the past 20 years, global mortality among children younger than 5 years has decreased by 41%, from 87 deaths per 1000 livebirths in 1990 to 51 in 2011.  During the same period, development assistance for maternal, newborn, and child health has increased, and has even done so through the global economic crisis. Recent international initiatives, such as Every Woman Every Child, the UN Commission on Life-Saving Commodities for Women and Children, and A Promise Renewed, have also reinvigorated the child survival agenda. But the job is far from finished. …

 … In this Lancet Series, we focus on childhood pneumonia and diarrhoea—the leading causes of death in the post-neonatal period. In the past, these two illnesses have been viewed separately in health programmes and in the minds of international agencies, donors, and governments. However, through many consultations, front-line workers have made it clear that they believe that more cooperation and coordination is needed on the ground in the prevention and control of these two illnesses. They are right. Childhood diarrhoea and pneumonia share many risk factors (…), and integrated programmes to tackle these can reduce the incidence of, and deaths from, both illnesses.”

4.    WHO/UNICEF: New plan to address pneumonia and diarrhoea could save 2 million children a year

A new Global Action Plan launched by the WHO and UNICEF has the potential to save up to 2 million children every year from deaths caused by pneumonia and diarrhoea. The ‘Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea’ calls for closer integration of efforts to prevent and treat these two diseases and sets ambitious targets to reduce mortality rates and raise levels of children’s access to life-saving interventions.

The Guardian’s Sarah Boseley commented on the new Global Action plan and on the Lancet series.


US & global health


5.    Science Speaks – Obama 2014 budget: Continued support for Global Fund, paired with PEPFAR cut leave Blueprint goals in question

Rabita Aziz;

The Obama administration released its proposed budget for fiscal year 2014, with numbers that show a continued commitment to the Global Fund, but also a continued drop in funding for PEPFAR. This short article in Science Speaks also gives some info on the fate of other global health programs. For an overview of the Department of State & other international programs’ budget requests, see this  document from the White House. David Garmaise (Global Fund Observer) also commented on the rather positive news about Obama’s budget request for the GF.

Much advertised in the media was also the transformation of the US food aid program.

Some other encouraging Obama news then: as reported by Tom Murphy on Humanosphere, the Obama administration made good on its 2011 memorandum to support lesbian, gay, bisexual, and transgender (LGBT) rights with the announcement of a four year LGBT Global Development Partnership.

6.    Reuters – Prostitution policy splits NGOs in top court AIDS case

A Supreme Court case that challenges a law requiring anti-prostitution policies for HIV/AIDS programs seeking federal money has generated a split among non-profit groups that counsel sex workers overseas. The case (which will be considered by the Supreme Court on April 22)  involves a 2003 law that bars funding for groups that work on HIV/AIDS prevention but do not have a policy opposing prostitution and sex trafficking.

7.    Lancet (Editorial) – Mapping the mind—smart thinking for brain health?

On April 2, Barack Obama launched his most ambitious scientific research plan to date — the BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative. The programme aims to accelerate the development of new tools to map comprehensively, for the first time, the activity of the human brain. This Lancet editorial assesses the programme, also with a view on brain health around the world.


Lancet Correspondence on Option B+


This week the Lancet features a number of letters reacting to an earlier Lancet article  by Anna Coutsoudis and colleagues on Option B+.  In their article, Coutsoudis et al. cautioned against advocacy for Option B+ (lifelong antiretroviral treatment for all HIV-positive pregnant women, in order to prevent mother-to-child transmission (PMTCT)). We recommend all Option B+ related  Letters in the Lancet as well as the reply by the authors.

8.    Lancet Correspondence – Is Option B+ the best choice?

Eric Schouten et al.;

Option B+ was first proposed by Malawi as a novel approach to the rapid expansion of access to ART for HIV-positive pregnant women. Schouten et al. consider  Option B+ as the only choice for Malawi. “Option A and B are dependent on accessible, functional, and efficient laboratory services for CD4 count testing, and these will not be universally available in Malawi and most other countries in Africa in the foreseeable future. … The choice is to implement an impractical policy and accept low coverage of services, as Malawi did until mid-2011, or, on the basis of a “public health approach”, simplify the guidelines and eliminate bottlenecks known to impede universal access.” … “Malawi made its decision on the basis of implementation evidence and local circumstances, and we believe it would have been unethical not to choose Option B+. Several countries in similar situations, including Uganda, Zambia, and Rwanda, have shown great interest and have started planning for transition to Option B+. International agencies should support this approach.”

Other nice letters are from Hirnschall et al (focusing on the issue from the perspective of WHO’s role of setting global public health norms and standards);  Eric Goosby  (arguing that US guidelines already recommend treatment for all people irrespective of CD4 count, and that global guidelines recommend test and treat for certain subpopulations (ie, those with HIV and tuberculosis co-infection). He also stresses that failure to support countries that choose Option B+ would undermine country ownership);  Kellerman et al. argue that, even where all three regimens (A, B & B+) are feasible, Option B+ might be best.

The authors reply here. Among other things, they emphasize country-specific decision making and argue for improving access to measurement of CD4 cell counts, …

BRICs & health


9.    CFR (blog) – Coughing Dragon, Sneezing Elephant: China, India, and Global Health Governance

Stewart M. Patrick;

Noting the release of a new Council on Foreign Relations (CFR) paper by Yanzhong Huang, titled “Enter the Dragon and the Elephant: China and India’s Participation in Global Health Governance,”  (see last week’s IHP newsletter) Stewart Patrick, aka “the internationalist”, comments.

In other BRICs news, we also recommend a Project Syndicate op-ed by Dani Rodrik. He reflects – somewhat disappointed – on the recent BRICs summit in Durban. He regrets the fact that the BRICs want to focus on infrastructure finance (through their own development bank) and says that what the world wants instead from the BRICs is greater leadership on today’s great global issues.

10. Lancet (World Report) – India’s patent case victory rattles Big Pharma

Patralekha Chatterjee;

Campaigners fear that drug companies may still try to patent slight modifications to their drugs despite India’s landmark ruling over Novartis’s drug imatinib. Patralekha Chatterjee reports (and also looks at the near future).

But India could still face tough times in the future. Brook Baker, an American academic working with Health GAP, a US non-profit, says: “The US Government has been putting diplomatic and trade pressure on India for years with respect to its adoption of strict standards of patentability. It has consistently chided India in its annual Special 301 Watch List at the behest of Big Pharma. It will be issuing a new Special 301 Watch List within the month, and you can be sure that India will be listed, with special emphasis both on the Novartis decision and the Natco compulsory license on Bayer’s cancer drugs.”

 Health activists in India are also concerned about the secrecy surrounding several free-trade agreements currently being planned or negotiated. Their immediate worry is about the intellectual property rights and investment provisions in the proposed free-trade agreement between India and the European Union, now in the final stages of negotiation.

11. The Atlantic – Why Chemotherapy That Costs $70,000 in the U.S. Costs $2,500 in India

Thomas Bollyky;

The tension in the patent system (as seen in the Novartis case) has been exposed before (see HIV battle), Bollyky argues. “Yet the emerging fight over cancer medicines threatens to be bigger, as it involves the emerging markets and disease groups on which the multinational drug industry has banked its future. …

The solutions to fights pitting cancer patients against patents in India are more likely to reside in making the current system of funding pharmaceutical R&D work better.”

12. BMJ – Can India pull off its ambitious National Health Mission?

Jeetha D’Silva;

India’s latest health mission, which it hopes will herald universal healthcare, builds on the success of its rural mission. But will it have the resources to do the job, asks Jeetha D’Silva.

Polio eradication


13. Lancet (World Report) – Ending polio—if at first you don’t succeed…

John Maurice;

The Global Polio Eradication Initiative (GPEI) has launched an “endgame strategy” that it hopes will rid the world of a disease that it has been fighting for nearly 25 years. John Maurice reports. He interviewed Bruce Aylward, WHO Assistant Director-General and the driving force behind the GPEI. The new “endgame strategy” will be officially unveiled in the last week of April. Aylward is generally upbeat.

Peter Piot also published a viewpoint in the Guardian on the polio challenge. In it, he says he’s “joining more than 400 scientists and technical experts from more than 75 countries in signing the scientific declaration on polio eradication, while more than 40 other leading universities and public health institutions are publicly promoting it. This statement from leading international scientists and technical experts emphasises the achievability of eradication and endorses the Global Polio Eradication Initiative’s new eradication and endgame strategic plan to reach and sustain eradication over the next six years.”


Health Policy & Financing


14. The world we want – Final report of the Thematic consultation on Health in the post-2015 agenda

As already mentioned in the introduction, the final report of the Thematic Consultation on Health in the post 2015 development agenda is now finalised.

15. One world blog – Stabilizing the supply of antimalarial drugs

Large-scale production of semisynthetic artemisinin was launched on April 11. In the words of Karen Grepin on her blog, “I learned that as of today, and thanks to the efforts of PATH’s OneWorld Health, Sanofi, and other partners, we now have the ability to produce synthetic versions of artemisinin which can be produced in about 3 months, can be more readily scaled, and can be produced in a much more controlled fashion. This is a remarkable milestone in the fascinating history of this drug.” See also Tom Paulson on Humanosphere on this  breakthrough.

16. Lancet (early online) – Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening

Dina Balabanova et al.;

In 1985, the Rockefeller Foundation published ‘Good health at low cost’ to discuss why some countries or regions achieve better health and social outcomes than do others at a similar level of income and to show the role of political will and socially progressive policies. 25 years on, the Good Health at Low Cost project revisited these places but looked anew at Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil Nadu, which have all either achieved substantial improvements in health or access to services or implemented innovative health policies relative to their neighbours. Attributes of success included good governance and political commitment, effective bureaucracies that preserve institutional memory and can learn from experience, and the ability to innovate and adapt to resource limitations. Furthermore, the capacity to respond to population needs and build resilience into health systems in the face of political unrest, economic crises, and natural disasters was important. These experiences show that improvements in health can still be achieved in countries with relatively few resources, though strategic investment is necessary to address new challenges such as complex chronic diseases and growing population expectations.

17. Lancet (Correspondence) – Civil registration and vital statistics—everybody’s business but nobody’s business

Alan Lopez et al.;

There has been some global action on civil registration and vital statistics (CRVS) systems, but by no means enough, according to Lopez et al. He says this growing global action is complemented by substantial regional momentum, which will be showcased at the first Global Summit on CRVS in Bangkok, Thailand, on April 18—19, 2013.

18. Lancet (Comment) – Cash-transfer programmes in developing countries

Stuart Gilmour et al.;

Gilmour and colleagues comment on recent research on (conditional & unconditional) cash transfer programmes in Zimbabwe. The results confirm the strong role that cash-transfer programmes—both unconditional & conditional ones —can have in poverty alleviation, but questions remain as to their effectiveness in improvement of health outcomes.  How then should such programmes be implemented, and what more needs to be known to realise their potential health benefits, the authors wonder. These programmes usually induce behavioural change in the target population through two main pathways: lowering of financial barriers to health services and raising awareness of beneficial behaviour. Interesting article.

19. Lancet  – Offline: the Stockholm syndrome

Richard Horton;

Horton reports on last week’s Global health meeting ‘Global health beyond 2015’ in Stockholm. He argues the meeting in Stockholm was different from other global health conferences. “Ministers in the Swedish Government spoke to a mostly non-medical audience—1400 people with an average age well below 40 years. They were joined by policy makers, diplomats, funders, scientists, students, activists, and businessmen. This in order to broaden the conversation about global health. The conference also asked whether it was “time to reposition Scandinavia in global health”, and the event seriously zoomed in on the role of young people and women. Read also about the clash between Hans Rosling and many of the other participants on the climate issue. Rosling’s view on climate change is that “it’s a development, not a health issue, and that extreme poverty should still be our overriding priority.” Many didn’t agree. The Stockholm Declaration, which will be finalized soon, will showcase a renewed vision for Sweden in global health.

20. NEJM (Perspective) – Global Concerns Regarding Novel Influenza A (H7N9) Virus Infections

Timothy M. Uyeki et al.;

Severe disease in humans caused by a novel influenza A virus that is distinct from circulating human influenza A viruses is a seminal event, Uyeki et al argue. It might herald sporadic human infections from an animal source  or it might signal the start of an influenza pandemic. “Therefore, the discovery of novel influenza A (H7N9) virus infections in three critically ill patients reported in the NEJM by Gao and colleagues  is of major public health significance. Chinese scientists are to be congratulated for the apparent speed with which the H7N9 virus was identified, and whole viral genome sequences were made publicly available in relatively short order. Because this H7N9 virus has not been detected in humans or animals previously, the situation raises many urgent questions and global public health concerns.”

It’s not really a key focus of this newsletter, but if you want to know more about H7N9, check out some KFF articles on the matter (see here for example, from early this week, or this  report on the development of a vaccine in the US & China) and today’s Economist (focusing on the fact that the situation presents a severe test for the new crop of Chinese leaders  – so far they seem to be doing not too bad). If you want to be up to date or are into pandemics, just follow Laurie Garrett on Twitter. (She even tweets in Chinese these days J, occasionally)

21. World Health Summit (regional meeting Asia – in Singapore) – Final statement

Health professionals, academics, civil society, industry, media, and

policymakers gathered in Singapore for the first Regional Meeting of the World Health Summit (8-10 April 2013). The theme for the meeting – “Health for Sustainable Development in Asia” – acknowledged that a healthy population is the basis for development, security, progress, social justice, and economic stability.    The Final M8 Alliance statement features the core values as well as a four-fold call to action.

For the opening day of the conference, see this short article (Peter Piot was one of the speakers, and H7N9 was on everybody’s mind).

22. Lancet (Editorial) – Measuring universities’ commitments to global health

The University Global Health Impact Report Card was released on April 4, marking a new effort to identify the standings of leading North American research universities in bridging the gap between research and roll out of treatments for neglected diseases. The report, sponsored by the Universities Allied for Essential Medicines, assesses the performance of 54 institutions on two key aspects—commitment to innovation in research that bears on the developing world and the use of open, socially responsible technology licensing that helps to ensure affordable access. Conclusion of this editorial: “The Report Card points out the tremendous inadequacies of current institutional commitments, but also provides a clear set of “stretch” goals to increase access to research that could help save millions of lives.”

23. Humanosphere – Outsourcing health care: The global growth of medical tourism

Jill Hodges;

Jill Hodges is a Seattle-based writer and lead editor of a (new) book ‘Risks and Challenges in Medical Tourism’. She published two articles on the growth of this globalized health industry (on the Humanosphere website).

24. WHO Bulletin (early online) – Development assistance for health in Africa: are we telling the right story?

Nathalie Van de Maele et al.;

The variation in levels and trends in development assistance for health

across data sets (compared in this paper) is substantial, the authors argue. Variation was greater at the country than at the regional level, partly because the different aggregates of development assistance for health have different meanings and partly because of incomplete reporting. They stress it is important to know what the different aggregates of development assistance for health reported in the different databases mean before deciding which ones to use to answer a particular policy question.

25. Global Health Promotion (Editorial) – ‘Alone we go faster, together we go further’: communities of practice in support of making access to health care available to the poor?

Fahdi Dkhimi et al.;

This editorial by our colleague is part of the new March issue of Global Health Promotion. “If everyone agrees today that each country must begin its transition to UHC without delay, the implementation of such an ambition has not yet been effected. One of the major challenges is to strengthen the equity in health financing, particularly to improve access to healthcare for the poor. … If the issue of resources is important, the problem of knowledge management is also crucial. The implementation of certain initiatives fails in its effectiveness due to an obvious lack of knowledge sharing, which leads to a repetition of certain errors in several different respects. Hence the idea to implement effective platforms for the production and sharing of knowledge, called communities of practice. The Community of Practice ‘Financial Access to Health Services’ (CoP FAHS) is one of these innovative modalities implemented in Africa. Its objective is to promote the exchange and coordination between actors mobilized around the issue of health financing and access to care.”

This Global Health Promotion issue also features an article on the Stellenbosch consensus statement (2011) on health promotion schools. Check it out.

26. Chatham House – The Grand Decade for Global Health: 1998–2008

Jon Lidén;

The decade 1998-2008 was a period of rapid growth in the resources devoted to global health problems and of unprecedented innovation in the way these resources were delivered. This paper by Jon Lidén is the second paper in a series related to the Centre on Global Health Security Working Groups, which are aimed at improving global health security.

27. World Bank – So what exactly is the ‘science of delivery’?

Adam Wagstaff;

In this blog post, Wagstaff zooms in on one of the recurrent themes in Jim Kim’s speeches, “the science of delivery”, useful in the health sector but also for all other WB areas of work.

28. JAMA (Viewpoint) – Stemming the Global Trade in Falsified and Substandard Medicines

Lawrence O. Gostin et al.;

Gostin et al. give some suggestions on how to stem the global trade in falsified and substandard medicines.

29. Health Economics journal – Priority setting in global health: towards a minimum DALY value

Tom Drake;

Rational and analytic healthcare decision making employed by many national healthcare-funding bodies could also be expected from global health donors, Drake argues. Cost effectiveness analysis of healthcare investment options presents the effectiveness of a particular action in proportion to the resources required, and cost effectiveness thresholds, while somewhat arbitrary, define the level at which the investment can be considered value for money. Currently, cost effectiveness thresholds reflect the national budget context or willingness-to-pay, which is problematic when making cross-country comparisons. A global minimum DALY value would reflect a universal minimum value on human health, irrespective of a national provider’s willingness or ability to pay.


Global Health announcements

  • Next week on 18th and 19th April, African Health and Finance Ministers will be meeting at the World Bank  to discuss health financing options. The President of the World Bank, Jim Kim, will be addressing the Ministers. Civil society organisations ask Kim in a letter to seek the leadership of African ministers on Universal Health Coverage and to follow financing policies that work. The letter asks Jim Kim more specifically to:  1. promote the removal of user fees and offer World Bank support to governments that do  2. promote the need to scale up public financing (and not private financing) 3. clarify the lack of evidence to support health insurance in low and middle income countries. (if you are from civil society, and you want your organisation to sign the letter, you can contact Monica Mutesa from Oxfam in Zambia at The deadline for signing the letter is Monday 15th of April.
  • Conference ‘Health Systems in Asia’ in Singapore (December 2013): call for abstracts (Deadline is 21 June)

Health Systems in Asia is an interdisciplinary, social science conference, focusing on health systems adopted, or being considered for adoption, in Asian countries and their associated unique implications due to rapid economic, social, demographic and epidemiologic changes in the region. The conference is the 2nd to be held in association with Social Science & Medicine, the world’s most cited social science journal, building on the success of the 2011 event. A Special Issue of selected papers presented at this conference will be published in Social Science & Medicine after the event.

Global health bits & pieces

  • Five Japanese pharmaceutical giants are teaming up with the Bill & Melinda Gates Foundation and Japan’s government to develop new medicines, vaccines, and diagnostics for infectious diseases in developing countries. The Global Health Innovative Technology (GHIT) fund will see Takeda, Astellas, Daiichi-Sankyo, Eisai and Shionogi partner with the Gates Foundation and the government to provide grants for research funding that will help tackle HIV, malaria, tuberculosis and neglected tropical diseases (NTDs). This is the first public-private partnership of its kind in Japan.
  • There’s a new Health Affairs issue, themed ‘The triple aim goes global’. High-income countries are struggling to pursue better health, better care, and lower cost.
  • A article reports on a recent report by PwC India, saying that mHealth applications could save more than a million lives in Sub-Saharan Africa over the next five years.
  • Another  article zooms in on Pope Francis and the (high) hopes for health reform, social activism, a new position versus science, condom use, climate change, …  By the way, the pope met with Ban Ki Moon this week (see this Devex article).




30. HP&P – 10 best resources on … mixed methods research in health systems

Sachiko Ozawa et al.;

To provide researchers and programme managers with a guide to mixed methods research in health systems, the authors reviewed the best resources with a focus on LMICs. They selected 10.

31. Plos (blog) – Mendeley and Elsevier;

Martin Fenner;

Elsevier bought Mendeley. Fenner: “For me this trend signals that publishers have realized that we are moving into an Open Access publishing model, which in contrast to subscription publishing is not about owning the content, but about providing valuable services around content that is free to read and reuse.”

32. NBER working paper – Pay-for-performance incentives in Low- and Middle-income country health programs

Grant Miller et al.;

This chapter surveys experience with performance pay in developing country health programs. In doing so, it focuses on four key conceptual issues: (1) What to reward, (2) Who to reward, (3) How to reward, and (4) What unintended consequences might performance incentives create. The authors highlight that the use of performance pay has outpaced growth in corresponding empirical evidence. Moreover, very little research on performance incentives studies the underlying conceptual issues they outline




  • The European Report on Development 2013: The European Commission has unveiled a blueprint for global development aid and called on world leaders to replace the MDGs with an international aid framework based on sustainable and inclusive development tackling poverty at its roots. The report was commissioned by European states,  prepared by the Overseas Development Institute (ODI), German Development Institute/Deutsches Institut für Entwicklungspolitik (DIE) and the European Centre for Development Policy Management (ECDPM). The Guardian’s Global Development Professionals Network  provides a summary of the report’s main findings.
  • A new ODI report highlights the implications of the current separation of the discourses on private climate finance (PCF) and on subsidies, and the opportunities that exist to unlock climate-compatible investment by linking these fields. Though climate finance aims to enable climate compatible development (CCD), this paper points out that, within developing countries, subsidies to fossil fuels (alone) currently dwarf any efforts toward CCD through climate finance. For the 42 developing countries where data are available on either subsidies or climate finance, the scale of fossil-fuel subsidies to consumers, at $396 billion in 2011, is 75 times higher than the average annual approved climate finance of $5 billion from 2010-2012.
  • If you want to know more about Turkey’s increasing activities in Africa, check out this article in the Guardian.
  • Finally, Howard Buffet, Warren’s son, is pushing the international community to fully restore aid to Rwanda.

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