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2. Global health at a crossroads: policy recommendations in light of the Lancet Global Health 2050 Report
- Author:
- Christoph Strupat, Marco Schäferhoff, Martin Siegel, and Anna-Katharina Hornidge
- Publication Date:
- 01-2025
- Content Type:
- Working Paper
- Institution:
- German Institute of Development and Sustainability (IDOS)
- Abstract:
- At a time of global crisis and competing priorities, investing in health is among the most impactful and cost-effective decisions governments and stakeholders can make. Beyond being a fundamental right, health is a catalyst for growth, stability and resilience – particularly in uncertain times. The new Global Health 2050: the path to halving premature death by mid-century (Global Health 2050) report (Jamison et al., 2024) of the Lancet Commission on Investing in Health (the Commission) builds on a legacy of evidence-driven reports to provide strategies for making health a cross-cutting enabler of the Sustainable Development Goals (SDGs). Global Health 2050 provides a roadmap for further health improvements in all countries by mid-century, arguing that by 2050 countries can reduce by 50% the probability of premature death (PPD) in their populations. The Commission calls this goal “50 by 50”. Germany has solidified its role in global health through significant investments in the health sector and by designating global health as a political priority, as demonstrated by its Global Health Strategy and the inclusion of global health as one of the core themes of the Federal Ministry for Economic Cooperation and Development (BMZ). Given this political priority, it is essential to assess the implications of the Global Health 2050 report for Germany’s global health agenda, especially as global health stands at a crossroads following the withdrawal of the United States (US) from the World Health Organization (WHO) and cuts to its global health programmes. Therefore, the aim of this policy brief is to build upon the Commission’s findings and draw from scientific evidence to provide key recommendations for Germany’s global health agenda. Five recommendations have been synthesised that align with Germany’s global health engagement and offer promising strategies to help achieve the 50 by 50 goal: 1. Sustain or ideally increase funding for the Gavi, The Vaccine Alliance, and the Global Fund to Fight AIDS, Tuberculosis and Malaria at the upcoming replenishment conferences and strengthen Germany’s global health leadership through strong bilateral support, investments in pandemic preparedness and response (PPR) and better interministerial coordination. 2. Reconsider non-communicable diseases (NCDs) in future strategic direction of German international cooperation by reducing financial and geo-graphical barriers to access to medicines and addressing key NCD risk factors. 3. Promote health taxes on tobacco, alcohol, and sugar-sweetened beverages that can serve as an effective strategy to improve public health and generate domestic revenue. 4. Increase funding for R&D in neglected diseases. Expand regional manufacturing, and enhance global health innovation coordination to strength-en global health security and reduce dependence on external supply chains. 5. Nepal serves as a good example of Germany’s bilateral health and social protection support: advancing the 50 by 50 goal could be achieved by strengthening national health insurance, addressing climate risks, expanding health taxes and enhancing pharmaceutical access through the Arrow mechanism.
- Topic:
- Development, Investment, Public Health, Global Health, and Disease
- Political Geography:
- Global Focus
3. Multilateralism Index 2024
- Author:
- Institute for Economics and Peace (IEP)
- Publication Date:
- 10-2024
- Content Type:
- Special Report
- Institution:
- Institute for Economics & Peace (IEP)
- Abstract:
- There are growing calls to transform the multilateral system, which is widely seen as being in crisis. Yet solving the crisis of multilateralism requires understanding what that crisis entails. What parts of the multilateral system are in crisis, and what parts are still functioning? Where is commitment to multilateralism flagging, and where does it remain strong? Where is multilateral action failing to translate into concrete results, and where is it delivering? Who is being left out of multilateral engagement, and who is being included? And what are the trends over time? To help answer these questions, the International Peace Institute (IPI) and the Institute for Economics and Peace (IEP) developed the Multilateralism Index. This 2024 edition of the Index assesses changes in international cooperation between 2013 and 2023 across five domains: Peace and Security, Human Rights, Climate Action, Public Health, and Trade. Each domain is evaluated across three dimensions: Participation, Performance, and Inclusivity
- Topic:
- Security, Climate Change, Human Rights, Multilateralism, Peace, Trade, Public Health, and International Order
- Political Geography:
- Global Focus
4. Beyond the “Gavi-Eligible”: High-Leverage Opportunities for Gavi to Enhance Vaccine Access and Uptake in Ineligible Middle-Income Countries
- Author:
- Rachel Bonnifield, Morgan Pincombe, and Janeen Madan Keller
- Publication Date:
- 04-2024
- Content Type:
- Policy Brief
- Institution:
- Center for Global Development (CGD)
- Abstract:
- The global locus of undervaccination is increasingly shifting from the poorest countries in the world—which are eligible for support from Gavi, the Vaccine Alliance (Gavi)—to middle-income countries (MICs) that do not qualify for traditional Gavi support. Given these growing challenges, Gavi must rethink its engagement with those MICs that are ineligible for traditional support. Although this engagement is intended to be “catalytic” and has been intentionally targeted to country needs, it also has been relatively small-scale and ad hoc. Gavi’s next five-year strategic period from 2026 to 2030, known as “Gavi 6.0,” offers a window of opportunity for its board and leadership to consider new and different ways for Gavi to engage with MICs to advance global vaccine access and improve vaccination outcomes. To have the greatest impact in this context, Gavi must lean into its comparative advantage in market shaping and demand consolidation to drive its contributions to global vaccination efforts with finite resources. We offer recommendations for Gavi to operationalize broader engagement with MICs, specifically by enabling an expanded cohort of MICs to access more affordable prices for both newer, costlier vaccines and future vaccines via opt-in framework agreements and by supporting a global coordinating hub to shape a forward-looking immunization innovation agenda.
- Topic:
- Public Health, Vaccine, Global Health, and Middle-Income Countries
- Political Geography:
- Global Focus
5. Starting from the Source: Methods and Priorities for Explaining Lead Exposure
- Author:
- Rachel Bonnifield
- Publication Date:
- 08-2024
- Content Type:
- Policy Brief
- Institution:
- Center for Global Development (CGD)
- Abstract:
- Lead is a dangerous neurotoxin, and lead poisoning remains one of the most serious and neglected public health challenges in the developing world, with major negative impacts on global health, education, and overall economic development. There is now growing international momentum to mitigate lead pollution, with the goal of dramatically reducing human lead exposure and consequent adverse effects. Yet before lead exposure can be effectively mitigated, it is essential to understand why humans are being exposed to lead in the first place and therefore how policymakers can intervene to stop further exposure. To date, such research into the major sources of lead exposure—broadly referred to as source assessment—in developing countries has been limited. Thus, there is limited information and no global scientific consensus about the most important causes of global lead exposure. Given growing global interest in addressing lead poisoning, there is an urgent need to better understand the major sources of lead exposure in different settings by increasing the volume and quality of related research. Tailored to a policy audience, this paper offers a state-of-the-science review of methods for doing so. First, it provides background for understanding lead exposure—that is, how and why lead enters the environment, how it behaves once there, and how environmental lead results in elevated blood lead levels for humans. Second, it outlines basic principles for source assessment, including a discussion of objectives and terminology. Third, it details the range of methods available for understanding the sources of lead exposure and describes how such methods can be used in combination to understand major sources of lead exposure in a given context. Finally, it considers major policy-relevant gaps in the literature base about sources of global exposure and offers suggestions for a research agenda in this space.
- Topic:
- Development, Public Health, Global Health, and Lead
- Political Geography:
- Global Focus
6. Financing the Pandemic Cycle: Prevention, Preparedness, Response, and Recovery and Reconstruction
- Author:
- Victoria Fan, Sun Kim, Diego Pineda, and Stefano Bertozzi
- Publication Date:
- 08-2024
- Content Type:
- Policy Brief
- Institution:
- Center for Global Development (CGD)
- Abstract:
- The COVID-19 pandemic exposed critical gaps in the global response to health crises, particularly in the financing of pandemic prevention, preparedness, response, recovery, and reconstruction. This paper presents a comprehensive framework for pandemic financing that spans the entire pandemic cycle, emphasizing the need for timely, adequate, and effective financial resources. The framework is designed to support policymakers in both low- and middle-income countries (LMICs) and high-income nations, providing a guide to appropriate financing tools for each stage of a pandemic, from prevention and preparedness to response and recovery. Key economic concepts such as global public goods, time preference, and incentives are explored to underscore the complexities of pandemic financing. The paper also highlights the importance of timely, accessible, and sustainable financial instruments. The paper lists the pandemic financing instruments used for health during the COVID-19 pandemic, identifying 23 different tools. We also used the IHME 2024 Financing Global Health database to estimate that US$91.6 billion was spent for COVID-19 health support, primarily for response financing, over 2020 to 2023. The COVID-19 pandemic wrought significant economic impacts on the order of trillions of dollars, even as investments in pandemic preparedness to mitigate future risks is relatively small, on the order of $10 billion annually. The paper concludes with policy recommendations, calling for the establishment of a rapid-response financing mechanism, tailored to the unique challenges of pandemics, and a redesign of global health governance to better address these threats.
- Topic:
- Finance, Crisis Management, Public Health, Pandemic, and COVID-19
- Political Geography:
- Global Focus
7. Lessons from COVID-19: Managing Borders in the Next Global Public-Health Crisis
- Author:
- Meghan Benton and Lawrence Huang
- Publication Date:
- 03-2024
- Content Type:
- Policy Brief
- Institution:
- Migration Policy Institute (MPI)
- Abstract:
- In March 2020, the global mobility system shut down in previously unimaginable ways. As COVID-19 cases multiplied, governments closed borders and introduced sweeping travel restrictions, entry bans, and suspensions of asylum and refugee resettlement. These policies evolved over time, giving rise to a complex web of mobility restrictions, conditions, and exemptions for certain groups, with undeniable consequences for societies and economies around the world. Four years on, migration has returned to the pre-pandemic norm, but governments should not forget the costs of unplanned, long-lasting, and stringent travel restrictions. This is a key moment to examine the pandemic’s lingering impacts on mobility as well as to build a bench of evidence-based tools to manage mobility during future public-health crises. This brief highlights the importance of mobility measures that are clear, equitable, streamlined, and prepared to adapt to future challenges. This capstone brief concludes a series of studies by MPI’s Task Force on Mobility and Borders during and after COVID-19 that explores opportunities to improve international coordination regarding border management during public-health crises. Regional case studies in this series look at Asia and the Pacific, Europe, the Middle East and North Africa, and South America. Its thematic studies consider the role of digital health credentials in facilitating movement, the use of risk analysis to shape border policies, and the rise of remote work and “digital nomads.”
- Topic:
- Migration, Borders, Crisis Management, Public Health, and COVID-19
- Political Geography:
- Global Focus
8. The humanitarian response to COVID-19: Lessons for future pandemics and global crises
- Author:
- Emmeline Kerkvliet, Samir Hafiz, and Susanna Morrison-Metois
- Publication Date:
- 10-2024
- Content Type:
- Commentary and Analysis
- Institution:
- ALNAP: Active Learning Network for Accountability and Performance
- Abstract:
- The COVID-19 pandemic was unparalleled in scope and scale, and the response tested the humanitarian system in new and unforeseen ways. While funding was not able to keep pace with the massive rise in global needs, the system proved to be extraordinarily resilient. However, neither the crisis itself nor the response to it should be understood as exceptional. Despite its many achievements and adaptations, the humanitarian response walked a well-trodden path. Humanitarian actors often defaulted to their usual, top-down ways of working, revealing perennial problems in the current formal international humanitarian system. Evaluations emphasise that the response was carried out under significant constraints – unpredictability, scarcity of information and limited humanitarian access – but caution should be exercised against interpreting these constraints as justifications for the shortcomings of the response. There were striking parallels between the operating environment of COVID-19 and other crises, which are not new to humanitarians. In framing the pandemic as an exceptional crisis, there is a real risk of diminishing the importance of learning and the need for transformative change within the sector. ALNAP 's analysis suggests that there is much to be learned – and further researched – from the response to COVID-19, which will be useful in responding to future public health emergencies, as well as other major crises. This evaluation synthesis focuses on nine key areas of the humanitarian system's response to the pandemic: sense-making and resource mobilization; needs prioritization and inclusion of the most vulnerable; adaptation of the humanitarian system; meeting the needs; localization; community engagement; coordination and collaboration with partners; utilization of learning from the Ebola and other public health responses; and evidence gaps and areas for further research. Download main report file
- Topic:
- Crisis Management, Public Health, Pandemic, COVID-19, Monitoring, Humanitarian Assistance, and Evaluation
- Political Geography:
- Global Focus
9. 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
10. Facing the next public health emergency: How do we know how (un)prepared we are?
- Author:
- Christian Haddad and Hugh Schmidt
- Publication Date:
- 07-2023
- Content Type:
- Policy Brief
- Institution:
- Austrian Institute for International Affairs (OIIP)
- Abstract:
- In the realm of political preparedness, numerous benchmarks, metrics, and best practice models have emerged as integral sites in the ongoing debate. Taking the Global Health Security Index as a specific example, this paper delves into the advantages and disadvantages of such global security rankings. This analysis aims to explore the potential uses and drawbacks of employing metrics to evaluate and modify (inter-)national preparedness plans. Situating this discussion within the broader context of the escalating significance of crisis preparedness and management, particularly in the face of acute disruptions to vital infrastructures and the immense costs they entail, as well as their adverse impact on public health and societal safety. However, the findings of this analysis reveal a notable political and strategic risk associated with an excessive reliance on these metrics. It is important to recognize that these metrics not only rely on robust scientific methodologies but also rest upon selective assumptions about the world and the definition of threats. The case of the Global Health Security Index serves as an example, as the assumptions underpinning these metrics have proven inaccurate in the face of an actual pandemic. Consequently, overconfidence and misguided approaches to crisis preparedness have ensued. Additionally, this work offers a concise historical overview of preparedness thinking, outlines the field of Global Health Security, presents the existing metrics employed, and critically reflects on these tools. While metrics provide valuable insights, they should be approached with caution and an awareness of their limitations. By adopting a critical lens and recognizing the political dimensions inherent in these metrics, policymakers can make more informed decisions and develop more effective preparedness plans in an ever-evolving world of crises.
- Topic:
- Security, Governance, Public Health, COVID-19, and Global Health
- Political Geography:
- Global Focus