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Cost-effectiveness vs. universal health coverage. Is the future random?

Adam Wagstaff's picture

I've been blogging a bit about Universal Health Coverage (UHC) recently. In my "old wine in a new bottle" post, I argued that UHC is ultimately about ensuring that rich and poor alike get the care they need, and that nobody suffers undue financial hardship from getting the care they need. In my "Mrs Gauri" post, I used my colleague Varun Gauri's mother as a guinea pig to see whether the general public feels that UHC is a morally powerful concept and whether it could be expressed in a way that the general public would find accessible.

My sense from Ms Gauri's comment on the post, is that the answer to both questions could well be Yes. So far so good.

Some bad news—resources are finite

But before we place orders for colorful placards and huge banners with my suggested slogans "Everyone should get the care they need!" and "End impoverishment due to health spending!", we should break some bad news to Ms Gauri and the rest of the general public: resources are finite, and especially in poor countries the available resources won't allow us to get to UHC anytime soon.

Lifting people out of poverty through ‘managed’ urbanization

Jos Verbeek's picture
The Global Monitoring Report (GMR) is the World Bank’s and the International Monetary Fund’s vehicle to not only report on progress toward the Millennium Development Goals (MDGs) but, equally importantly, to analyze a theme relevant for development in general and the MDGs in particular.

Kaushik Basu, the world economy, humility, and jobs

Merrell Tuck-Primdahl's picture

At his Sabanci lecture yesterday on ‘Emerging Nations and the Evolving Global Economy’, Kaushik Basu predicted that sluggish growth will likely prevail overall for the next two years, as the baton of economic growth is handed over from industrialized countries to developing countries. He cautioned that countries have bought time with liquidity injections and other stimulus measures, but that will not do anything to fix deeper structural problems.

To hear his talk, along with his views on the recent austerity debate that reached a fever pitch over the past 10 days, listen to the audio of the full lecture and question and answer session here.

Kaushik elaborated on some of his ideas for getting the world out of the current ‘time-buying’ phase in an April 23 piece in Project Syndicate op ed ‘Two Policy Prescriptions for the World Economy.’ Dani Rodrik was especially taken with Kaushik’s opening line that “One thing that experts know, and that non-experts do not, is that they know less than non-experts think they do.” This pointed to the hard truth that the austerity debate has revealed that policy setting in today’s world is a highly uncertain business and that humility should be the order of the day.

The Science of Delivery: whatever we call it, we have a problem - a reply to Wagstaff

Nick Manning's picture
In two posts (post one and post two) over the last month Adam has tried to get hold of the science – or “sciences” – of delivery. He boils them down to the idea that “the world has invested too much in what to deliver and too little in how to deliver it,” as a result of which millions of people are not reached and fail to benefit from development projects.

Mixed picture on MDG attainment

Jos Verbeek's picture

This year’s report card on where the world, the regions, and the developing countries are with regard to attaining the various Millennium Development Goals (MDGs), shows quite a diverse picture. As the Global Monitoring Report 2013 points out, progress toward the MDGs has not been universal and there are many poor countries that are still very far away from the targets where we want them to be by 2015. 

If we take a look at progress towards attainment of the MDGs, we can conclude that four out of 21 targets have been met by 2010, well ahead of the 2015 deadline. Note that even though there are 8 Goals, there are 21 targets and about 56 indicators through which the world tries to monitor their progress.

From Net to Gross Capital Flows

Sergio Schmukler's picture

The financial crises of the last three decades have spurred a very large interest on international capital flows. Although most of the work in the topic has concentrated on the behavior of net capital flows, much less is known about the behavior of gross capital flows (the difference between capital inflows by foreigners and capital outflows by domestic agents).

The overwhelming focus on net flows represents a serious shortcoming because gross flow are much larger and much more volatile than net flows, and their size and volatility have been growing substantially faster, as we discuss in a recently published paper and Vox column (Broner et al., 2013a and b).

It is time to shift the attention from net capital flows to gross capital flows.

Brown University President Christina Paxson on Higher Education in the Developing World

Merrell Tuck-Primdahl's picture

In the 1980s it was considered a given that most low-income countries over-invest in tertiary education. But that tired assumption is being upended in today’s world of borderless universities and globe-trotting skilled workers. A higher education undoubtedly generates a positive return for most people, whether in advanced or developing countries. However, policymakers should heed the warning about not jumping too fast by focusing on higher learning when in many countries, getting a solid secondary education is the key to climbing the ladder toward prosperity. Also, the importance of getting the organizational structure of universities right is often undervalued, with the result that far too many academic institutions fail to graduate people who are equipped to compete in the global workforce, or, aiming even higher, who are qualified to change the world for the better.

These were some of the takeaways I gleaned from Brown University President Christina Paxson’s lecture on April 26 at the World Bank.

DIY: Measuring Global, Regional Poverty Using PovcalNet, the Online Computational Tool behind the World Bank’s Poverty Statistics

Shaohua Chen's picture
World Bank Group President Jim Yong Kim recently announced ambitious goals to end poverty and boost shared prosperity, with a target to reduce the percentage of absolute poor – those living on or less than $1.25 a day (in 2005 PPP) – to 3 percent by 2030. The Bank, he said, will also focus on expanding opportunities for those living at the bottom 40 percent of the income or consumption distribution in each country.

IT maven Nandan Nilekani explains Unique I.D. system to reach India's masses

Merrell Tuck-Primdahl's picture

What breakthrough will involve barefoot banking for millions of people, allow welfare and other benefits to be electronically transferred to some of the poorest people in the world and be scaled up in a few years time to reach 1 billion people or more? The answer is 'Aadhaar', the Hindi name that the Unique Identification Authority of India has given to the massive project that will provide unique I.Ds to 600 million by 2014 and eventually to the entire population of the country if all goes as planned.

Of globalization’s promises and perils

Swati Mishra's picture

As a student in 2003, I had an opportunity to interview a social activist about food security in India. Among other things, she blamed globalization for the slow demise of the local food industry. She went a step further and labeled globalization as depriving people (small scale farmers and workers) of their livelihoods. Her solution for India to become a leader in the food industry was by staying local, small, and forming cooperatives rather than fostering large agribusiness. This was quite a contrasting view at a time when India was starting to see benefits from its economic liberalization. In retrospect, I was interviewing someone who was ahead of a trend where activists were increasingly wary about the downsides of globalization and its impact on development.

Since then, globalization has sped up and contentious debates over who ultimately benefits have grown. And just as finance ministers from various countries were converging on Washington to discuss vital issues like extreme poverty, global macroeconomic prospects, jobs creation, and inclusive growth, revisiting globalization seemed germane to tackling development challenges.

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