Newsletter

Let’s Chat: How to Make UHC a Reality for Everyone, Everywhere

This blog post was written by the Center for Global Development (CGD) Global Health Policy Team as part of GHC’s Member Spotlight Series. The post is adapted from a World Health Day preview first posted on CGD’s Global Health Policy blog on April 5. You can check out the original post here and highlights from the Twitter chat hereThe Center for Global Development works to reduce global poverty and inequality through rigorous research and active engagement with the policy community to make the world a more prosperous, just, and safe place for all. They are a 2018 Global Health Council member.

On the eve of World Health Day, GHC and CGD co-hosted a Twitter Chat on how we can work together to improve access to comprehensive, quality health care services in the developing world. Over the course of the hour, participants were asked questions like, “What are key levers to improve efficiency in health systems on the journey towards UHC?” and “How do we change the narrative and view women as drivers of change in global health, not only as beneficiaries?” in a discussion moderated by CGD COO and Senior Fellow Amanda Glassman and GHC President and Executive Director Loyce Pace. You can find key moments and takeaways from the #HealthForAll chat here.

Each year, millions of people fall into poverty because they have to pay out of pocket for medical care. At least half of the world’s population does not have access to essential health services. Universal health coverage (UHC) is the goal of ensuring that everyone, everywhere can access quality health services without the risk of financial hardship.

We can make UHC happen in our lifetime by targeting investments and incentives on the highest impact interventions among the most affected populations in developing countries. Countries at all income levels are proving that UHC can be both achievable and affordable. However, current global funding has leveled off while the need for life-saving services and products has not. Governments and global health funders need to do more with existing resources.

We at CGD have been advocating for UHC for years, using evidence-based research to inform our policy recommendations. We’ve hosted events, convened working groups, contributed to the creation of international networks, produced podcasts, and written extensively on UHC’s potential—when done in an evidence-based, ethical way—to improve both the equity and reach of global healthcare. From our Twitter Chat, we are excited to be reminded that many of you feel the same way.

What’s In, What’s Out. A recent CGD publication that serves as a guidebook for the creation of health benefits plans to promote universal health care.

Last week, we hosted a breakout session at the World Bank’s Third Annual UHC Financing Forum, which examined the role of health commodity procurement as a core element of equitable and universal health coverage. In the coming months, we will continue our work in UHC by highlighting three areas that will impact efficiency and achieve more health for the same amount of money, particularly in low- and middle-income countries:

1) Adoption of an explicit, evidence-based Health Benefits Package—a defined list of services that are and are not subsidized—is essential in creating a sustainable UHC system. It is key to evaluate how much health an intervention will buy for each dollar.
2) Better data and performance verification—combined with results-based funding—is a powerful instrument for UHC mechanisms. There is the potential to improve the efficiency of the health system and increase the productivity of health workers, while ensuring quality, equitable services at an affordable cost.
3) More systematic use of health technology assessment of the comparative effectiveness and costs of health technologies will provide the economic and clinical evidence needed for decisions about what products to purchase to achieve greater impact for money spent.

World Health Day kicked off a drumbeat of activities that will focus on increasing political will to advance health for all. The series of events include: the 71st World Health Assembly (WHA) in May, the United Nations General Assembly in September, and the marking of the 40th anniversary of the Alma-Ata Declaration in October in Almaty, Kazakhstan. It is anticipated that a new Alma-Ata Declaration will be set in motion and adopted at the WHA in 2019. These moments provide an opportunity to help shape and accelerate the UHC agenda.

We hope you will join us in our continued work on UHC. All of your thoughts and comments are welcome.

Advocacy Update ~ April 9, 2018

This post was written by Danielle Heiberg, Senior Policy & Advocacy Manager, and Melissa Chacko, Policy Associate.

The past two weeks were relatively quiet on Capitol Hill as Congress was in recess. Below are items that we are tracking:

Possible Rescission package

President Trump and Republicans are in discussions to force a vote on a package that would cut billions from the recently passed FY 2018 $1.3 trillion Omnibus. Although, the Omnibus was passed with bipartisan support, Republicans are facing pressure over the large spending package. There is no word on which accounts would be targeted or when a vote would take place.

Pompeo Nomination for Secretary of State

Please see below the nomination hearing date for The Honorable Mike Pompeo of Kansas as Secretary of State. For more information, visit: https://bit.ly/2qgKvaZ

1) Committee: Senate Foreign Relations Committee
2) Date: Thursday, April 12, 2018
3) Time: 10:00 am
4) Location: SD-419

 Moving Forward – FY 2019

As the FY 2019 process moves along, we hope that Congress again rejects the cuts proposed in the President’s budget which contains a 30 percent decrease in the foreign affairs budget, including global health programs at the U.S. Agency for International Development (USAID) and Department of State and cuts that were recommended for programs at the Department of Health and Human Services that support global health, global health research and development, and global health security.

Since the time that the President released his budget, advocates have been on the Hill, lobbying for strong investments in global health and submitting appropriation requests to members of Congress.

See Global Health Council’s funding chart: Funding Chart (FY 2017 comparison to FY 2018, and includes FY 2019)

Global Health Innovation Act Reviewed in the Senate Foreign Relations Committee

The Global Health Innovation Act (H.R. 1660) introduced by Representative Albio Sires (D-NJ) was reviewed by the Senate Foreign Relations Committee and reported favorably without amendment. The bill supports global health research and development by encouraging the development of health products that are affordable, accessible, and culturally appropriate in low-resource health systems. This bill will require USAID to submit a report on the development and use of global health innovations at the agency.

Making the Most of the Health Workforce

DOWNLOAD THE POLICY BRIEF

Achieving country commitments to universal health coverage requires maximizing the efficiency and effectiveness of the health workforce. The Health Finance and Governance (HFG) project supported country governments to optimize the quality and efficiency of the health labor market through policy development and implementation in health workforce production, regulation of the private sector, and initiatives to address maldistribution and inefficiencies. Over the course of the project, HFG engaged with countries on common challenges regarding human resources for health (HRH) – vacancies, ghost workers, incomplete HRH data, and health workers ill-prepared to meet population health needs, among others. Careful stakeholder engagement, incorporation of governance capacity building into HRH technical assistance, and thoughtful selection of interventions that could serve as levers for broader reforms contributed to the successful outcomes achieved with HFG’s support.

About HFG’s Advances in Health Finance & Governance Series

HFG’s Advances in Health Finance & Governance series is designed to highlight learning and lessons from the HFG project in nine core areas: domestic resource mobilization, strategic health purchasing, health financing strategies, expanding coverage through health insurance, financial data for decision making, governance, institutional capacity building, workforce and efficiency, and building understanding for universal health coverage.

The HFG project (2012-2018) is funded by the U.S. Agency for International Development (USAID) and is led by Abt Associates in collaboration with Avenir Health, Broad Branch Associates, Development Alternatives Inc., the Johns Hopkins Bloomberg School of Public Health, Results for Development Institute, RTI International, and Training Resources Group, Inc.

What Women Want: The World Wants to Know

This blog post was written by Stephanie Bowen, Director, Strategic Communication, White Ribbon Alliance, as part of Global Health Council’s Member Spotlight series. White Ribbon Alliance is activating a people-led movement for reproductive, maternal health and rights so that all girls and women realize their right to quality health and well-being. Launching on April 11thInternational Day of Maternal Health and Rights – the What Women Want campaign has a bold goal of reaching 1 million girls and women worldwide. White Ribbon Alliance is a 2018 Global Health Council member.

In just five days, global and national partners will officially launch the What Women Want campaign. Coinciding with International Day of Maternal Health and Rights, we are coming together under one unified, neutrally-branded campaign to put women’s and girls’ voices front and center in identifying their priorities for quality reproductive, maternal health and rights.

Based on a similar campaign by White Ribbon Alliance India, What Women Want will bring together individuals and organizations worldwide to ask this basic yet often ignored question: What is your one request for quality reproductive and maternal healthcare services? The answers heard in India were simple: My own bed. Enough supplies for mine and my baby’s medical needs. A clean facility. To be treated with respect. Simple, yet profound in that every woman should be able to expect these fundamental services, no matter where she lives, what religion she practices or her income level.

Despite significant progress, the current state of reproductive, maternal and sexual health for women and girls is far from optimal: Approximately 300,000 women die during pregnancy and childbirth every year. Millions still lack access to quality reproductive and sexual healthcare. And for girls age 15 to 19 years old, complications during pregnancy and childbirth are the leading cause of death.

Transforming this picture begins with women and girls.

The findings will be aggregated for a global picture of what women and girls want and disaggregated by country to help governments focus their human and financial resources in a way that will enhance health services, improve health outcomes and strengthen health systems.

More than 150,000 women across India were surveyed by WRA India about their top priority for quality reproductive, maternal healthcare. The results were profound. Photo courtesy: WRA India

A two-year campaign that will collect and analyze responses throughout 2018 and distill and disseminate findings throughout 2019, What Women Want is meant to be owned by the women and girls who respond and all the organizations who participate. Coordinated by the White Ribbon Alliance (WRA) Global Secretariat based in Washington, D.C., What Women Want is guided by a steering committee comprised of White Ribbon Alliance India, White Ribbon Alliance Global Secretariat, the Partnership for Maternal, Newborn and Child Health (PMNCH), Every Mother Counts (EMC), International Confederation of Midwives (ICM) and E4A-MamaYe—with many more participating partners. The steering committee is also consulting with representatives of Every Woman, Every Child (EWEC), the World Health Organization’s Quality of Care Network (WHO QoC Network), and the global Quality, Equity and Dignity Advocacy Working Group (QED AWG) to align efforts and ensure the voices of women and girls are incorporated into current quality-related initiatives.

We’ve built a website, translated surveys into French, Hindi, Spanish and Swahili, and put together shareable graphics to help get the word out. But if it’s going to be successful, we need to hear from as many women and girls as possible, particularly those in low and middle-income countries whose voice often goes unheard.

That’s where you come in!

Help launch the campaign by joining the What Women Want Twitter chat on Wednesday, April 11, 2018, from 10 AM ET to 11 AM ET and share why you are joining this movement for quality healthcare. Then take – and share –  the survey!

Together, we can ensure that all women and girls receive quality healthcare as they understand it.

 

Advocacy Update ~ March 26, 2018

This post was written by Danielle Heiberg, Senior Policy & Advocacy Manager, and Melissa Chacko, Policy Associate.

FY18 Omnibus Bill Passes

Six months into the fiscal year (FY), and five Continuing Resolutions and two government shutdowns later, we finally have a spending bill for FY 2018. With hours to spare before another potential shutdown, President Trump signed the $1.3 trillion package on Friday afternoon, but not before threatening to veto it earlier in the day.

Congress sent a strong message to the administration by rejecting the more than one-third cut that had been proposed in the President’s budget released last May. Overall, the omnibus bill contained $55.9 billion for the International Affairs Budget; this is $2.1 billion (3.8%) increase from FY 2017 enacted levels if you exclude the ISIS and famine supplementals.

For Global Health Programs at USAID and State, funding largely reflected levels determined by the Senate last year, with flat funding across all accounts and minor increases to maternal and child health (including the U.S. contribution to Gavi) and tuberculosis as compared to FY 2017 enacted. In addition, Congress provided additional funding to the Global Health Security account, using unobligated Ebola funds ($100 million) and replenishing the Emergency Response Fund ($35 million), for a total of $207.5 million. Of particular note for global health security activities is language requesting within six months a strategy from NSC, agencies, and the inter-agency group.

In the Labor, Health and Human Services section of the bill, CDC’s Center for Global Health and Emerging Infectious and Zoonotic Diseases both saw increases. In particular, Global Public Health was increased to continue critical global health security activities. Key accounts at NIH, including the Fogarty International Center also saw increases.

See related resources below:

Tillerson Out as Secretary of State, Pompeo Nominated for the Role; New CDC Director Named

In mid-March, President Trump fired Secretary of State Rex Tillerson and announced that CIA Director Mike Pompeo would be nominated to step into the role. Tillerson will formally remain in the position until March 31, but is delegating the running of the State Department to Deputy Secretary of State John Sullivan. Tillerson was instrumental in leading a “redesign,” or reorganization, plan at the agency, but it remains to be seen how or in what way those plans will continue under his successor. A confirmation hearing for Pompeo is expected in April. Normally during this time of year, the Secretary of State testifies before Congress on the President’s budget for the upcoming fiscal year; however, with the change in leadership, it is unclear if a hearing will be held to on the agency’s proposed budget.

In addition, last week, HHS Secretary Alex Azar named Dr. Robert Redfield as the new Director of CDC. Dr. Redfield recently served as a professor at the University of Maryland School of Medicine in Baltimore and is co-founder of the Institute for Human Virology. While Redfield has an extensive background in research, his broader public health experience in the U.S. or abroad is unclear. Some media and members of Congress have pointed to controversy around his screening proposals and vaccine research early in the U.S. AIDS epidemic. Others have noted his extensive work on addiction as a co-morbidity to HIV.

USAID Administrator Testifies on FY 2019 Foreign Assistance Budget 

Last week, the Honorable Mark A. Green, USAID Administrator, testified at a House Foreign Affairs Committee hearing on the FY 2019 Foreign Assistance Budget. While Committee members appreciated Administrator Green’s efforts to stretch USAID dollars to maximize results, the committee emphasized that the proposed one-third cut to USAID funding will “hamstring USAID’s efforts on these fronts.” Administrator Green agreed that this budget does not allow USAID to do everything and highlighted the importance of leveraging resources through domestic resource mobilization and the private sector. There was little emphasis on global health, but he did emphasize the agency’s commitment to women and girls. A few members, including Congresswoman Lois Frankel, inquired about the reinstatement and expansion of the Mexico City Policy. Administrator Green reaffirmed that the State Department and USAID will put out a more detailed evaluation of the rule at the end of the year.

A week before the hearing, members of Global Health Council met with Administrator Green to hear about his vision for global health and the agency. The small group discussion focused on agency funding and reform as well as the process and timeline for how countries transition from U.S. development assistance. Global Health Council was encouraged by the discussion and will continue to engage with Administrator Green and senior leadership at USAID on these issues.