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51. Performance-Based Incentives for Health: A Way to Improve Tuberculosis Detection and Treatment Completion?

Author:
Rena Eichler, Diana Weil, and Alexandra Beith
Publication Date:
04-2007
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Tuberculosis is a public health emergency in Africa, Eastern Europe, and Central Asia. Of the estimated 1.7 million deaths from TB, 98 percent are in the developing world, the majority being among the poor. In order to reach the MDG and the Stop TB partnership targets for 2015, TB detection rates need to double, treatment success rates must increase to more than 7075 percent, and strategies to address HIV-associated TB and multi-drug resistant TB must be aggressively expanded. DOTS, the internationally-recommended TB control strategy is the foundation of TB control efforts worldwide. A standard recording and monitoring system built on routine service-based data allows nearly all countries in the world to track progress in case detection and treatment completion through routine monitoring. This provides a good base for measuring the impact of different strategies for improving TB control outcomes.
Topic:
Health, International Organization, and Poverty
Political Geography:
Africa, Europe, and Asia

52. Advancing Economic Growth: Investing in Health

Author:
Rifat A Atun and Susan Fitzpatrick
Publication Date:
02-2006
Content Type:
Working Paper
Institution:
Chatham House
Abstract:
The traditional view of the relationship between economic growth and health had emphasized the impact of economic growth on improved health. However, from the beginning of the 'human capital' revolution in economics, there was a conceptual base that health is a core contributor to an individual's human capital, while health care is clearly a desired consumption good. Now, there is strong empirical evidence from both developing and developed countries which demonstrates the two-way relationship: that economic growth improves health but improved health also significantly enhances economic productivity and growth. In fact, it is not an exaggeration to say that no society has seen sustained economic progress when it has neglected investment in its people's education and health.
Topic:
Economics and Health
Political Geography:
Europe

53. Mad Cows and Ailing Hens: The Transatlantic Relationship and Livestock Diseases

Author:
Kate O'Neill
Publication Date:
05-2006
Content Type:
Working Paper
Institution:
Institute of European Studies
Abstract:
This paper examines how the emergence and spread of animal diseases such as bovine spongiform encephalopathy (BSE, or “mad cow disease”) or avian influenza have shaped the dynamics of transatlantic trade in live animals and meat products. It then compares the responses of the US and the EU, respectively, to looming, potentially long-term threats of epidemics to human and animal health, focusing particularly on recent outbreaks BSE and avian flu. It documents what appears to be a shift away from a sole reliance on trade embargoes to protect animal and public health from disease outbreaks to deeper, institutional responses on the part of the US and EU respectively. However, while it appears that the EU is learning from the US public health establishment, there is little evidence of transatlantic cooperation in this area.
Topic:
International Relations, Disaster Relief, Economics, and Health
Political Geography:
United States and Europe

54. A Policymakers' Guide to Dutch Disease

Author:
Owen Barder
Publication Date:
07-2006
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
It is sometimes claimed that an increase in aid might cause Dutch Disease—that is, an appreciation of the real exchange rate which can slow the growth of a country's exports— and that aid increases might thereby harm a country's long-term growth prospects. This essay argues that it is unlikely that a long-term, sustained and predictable increase in aid would, through the impact on the real exchange rate, do more harm than good, for three reasons. First, there is not necessarily an adverse impact on exports from Dutch Disease, and any impact on economic growth may be small. Second, aid spent in part on improving the supply side—investments in infrastructure, education, government institutions and health—result in productivity benefits for the whole economy, which can offset any loss of competitiveness from the Dutch Disease effect. Third, the welfare of a nation's citizens depends on their consumption and investment, not just output. Even on pessimistic assumptions, the additional consumption and investment which the aid finances is larger than any likely adverse impact on output. However, the macroeconomic effects of aid can cause substantial harm if the aid is not sustained until its benefits are realized. The costs of a temporary loss of competitiveness might well exceed the benefits of the short-term increase in aid. To avoid doing harm, aid should be sustained and predictable, and used in part to promote economic growth. This maximizes the chances that the long-term productivity and growth benefits will offset the adverse effects—which may be small if they exist at all—that big aid surges may pose as a result of Dutch Disease.
Topic:
Economics, Health, and Humanitarian Aid
Political Geography:
Europe

55. Health Improvements and Health Inequality during the Last 40 Years

Author:
Giovanni Andrea Cornia and Leonardo Menchini
Publication Date:
02-2006
Content Type:
Working Paper
Institution:
United Nations University
Abstract:
This paper juxtaposes changes over the last forty years in income growth and distribution with the mortality changes recorded at the aggregate level in about 170 countries and at the individual level in 26 countries with at least two demographic and health surveys covering the last twenty years. Over the 1980s and 1990s, the infant mortality rate, under-5 mortality rate, and life expectancy at birth mostly continued the favourable trends that characterized the 1960s and 1970s. Yet, especially in the 1990s, the pace of health improvement was slower than that recorded during the prior decades. In addition, the distribution between countries of aggregate health improvements became markedly more skewed. These trends are in part explained by the negative changes recorded in sub-Saharan Africa and Eastern Europe, but are robust to the removal of the two regions from the sample. This tendency is observed also at the intraregional level, with the exception of Western Europe. Thirdly, demographic and health survey data for 26 developing countries point to a frequent divergence over time in the within-country distribution of gains in the infant mortality and under-5 mortality rates among children living in urban versus rural areas and belonging to families part of different quantiles of the asset distribution. The paper concludes by underscoring the similarities and linkages between changes in income inequality and health inequality and suggests some tentative explanations of these trends without, however, formally testing them.
Topic:
Development, Health, and Human Welfare
Political Geography:
Europe and Eastern Europe

56. Treatment of Coronary Artery Disease: What Does Rationing Do?

Author:
Henry J. Aaron
Publication Date:
12-2005
Content Type:
Policy Brief
Institution:
The Brookings Institution
Abstract:
Providing all beneficial care to those who need it is rapidly becoming unaffordable, even for a nation as rich as the United States. The highly decentralized U.S. payment system is unique in its lack of effective levers for limiting health care spending, and managed care has largely been ineffective. A different solution, considered extreme by many in the United States, is rationing. The need to ration healthcare has long been a reality in the United Kingdom where healthcare spending must be covered by an annual budget accounting for only 7.6 percent of GDP—about half the U.S. share. These decisions are perhaps most difficult in regards to treatment of conditions that are literally matters of life or death, such as coronary artery disease. This brief examines reasons for the differences in treatment and outcomes in the United States and Britain, and discusses the difficulty of rationing care in the United States, where a unique payment system now uses income from those with health insurance to cover the medical costs of the uninsured.
Topic:
Health
Political Geography:
United States, United Kingdom, and Europe

57. Oxfam Publishing: Euro-Med: Ensuring a fair deal

Author:
Nishant Pandey and Yara Abdul-Hamid
Publication Date:
11-2005
Content Type:
Policy Brief
Institution:
Oxfam Publishing
Abstract:
When the Euro-Mediterranean Partnership (Euro-Med) was announced in Barcelona with a great fanfare in 1995, it was hoped that it would herald a new age in relations between the European Union (EU) and its ten southern Mediterranean partner countries, bringing unprecedented opportunities in the social, economic, and political fields.
Topic:
International Relations, Health, and Human Welfare
Political Geography:
Europe

58. Russian Health and Social Welfare: Limited Progress

Author:
Judyth L. Twigg
Publication Date:
08-2002
Content Type:
Working Paper
Institution:
Aspen Institute
Abstract:
It has become routine for Russian policy makers to characterize their various health and social problems—rising male mortality, HIV/AIDS, illegal drug use, even pension system reform—as threats to the stability and national security of their country. Russia's importance to American national interests was thrown in sharp relief by the events of September 11 and their aftermath. A stable, prosperous Russia is a crucial partner in the war on terrorism. The fact that so many of Russia's health and social indicators remain stagnant or in decline, despite limited improvement along some dimensions, should therefore be troubling to the United States.
Topic:
Government, Health, Human Welfare, Science and Technology, and Terrorism
Political Geography:
Russia, United States, Europe, and Asia