 In conjunction with the 20th anniversary of the 1993 World Development Report, a Lancet Commission revisits the case for investing in health and has developed a new framework to guide global health progress through 2035.The commission includes some incredible global health minds including Gavin Yamey (UCSF Global Health Group Evidence to Policy Initiative), Richard Feachem (UCSF Global Health Group), Agnes Binagwaho (Rwanda Ministry of Health), Richard Horton (The Lancet), Julio Frenk (Harvard SPH), and Dean Jamison (UW SPH)… among many other.Global Health 2035 Website is here.
The report and the livestream of the launch event are available now.Several working papers undertaken as part of the commission are also available online as pre prints.Here are some of the highlights:
- Time to revisit the case for investment in health and answer the question: “How should low-income and middle-income countries and their development partners target their future investments in health to tackle this complex array of challenges?”
- Progress has been made toward MDGs 4-6, yet significant preventable child, maternal and infectious disease mortality exist
- The concept of full income – monetary valuation of improved life expectancy; accounts for GDP changes as well as changes in life expectancy
- Value of additional life-years (VLYs), a unit inferred from people’s willingness to trade off income, pleasure, or convenience for an increase in life expectancy.
- Using VLYs – estimated economic benefit of investment in health for development from 2015-2035 demonstrates significant benefits.
- Greater attention needed in middle income countries – where most of the world’s poor now reside
- “Grand Convergence” in Health – a call for reduction in the rates of infectious, reproductive, newborn, child and maternal health (RNCMH) conditions in the LMICs with the highest burden down to levels presently seen in the best performing MICs by 2035
- Call for investment in curbing antibiotic resistance, increase investment in R&D for diseases disproportionately affecting LMICs from $3billion to $6 billion (US) by 2020.
- Provision of global public goods and management of externalities have been neglected for the past 20 years
- Fiscal policies are underutilized and effective mechanisms to decrease NCDs and injury burden
- Endorsement of two “pro-poor” pathways to Universal Health Coverage (UHC): 1) Publicly financed insurance for essential care (esp NCDs and injury); 2) Broader care creatively financed from sources other than poor populations
- UHC yields high health gains per dollar and benefits the poor most significantly
- Need to focus on population, policy and implementation research (PPIR)
The report is broken into seven sections:
- Twenty years of advances and unanticipated challenges
- Exploring the context for investment in health, from WDR 1993 through the present
- High rates of infectious disease, maternal and child morbidity and mortality
- The rise of NCDs and injuries
- The returns on investing in health
- Evidence for economic return from investment in health
- Stronger health systems and policies
- The role of diagonal approach to maternal child health, NCDs and injury
- Towards a “grand convergence” in health
- A plan for the “grand convergence” by 2035
- Investment to scale technology and systems
- NCDs and injury
- Framework to reduce NCDs and injuries
- Health Systems Finance
- The role of UHC and avoiding unproductive health cost escalation
- The essential role for international collective action
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