Global Health in Transition: A Synthesis Perspectives from International Organizations (1996) / Chapter Skim
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Global Comparative Assessments in the Health Sector
Global Comparative Assessments in the Health Sector
Pages 44-50
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From page 44... ...
Geneva: World Health Organization. Underlying the conclusions of the 1993 World Development Report is a series of comparative economic, epidemiologic, demographic, and institutional analyses undertaken collaboratively by the World Bank and the World Health Organization.
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From page 45... ...
Only in the Middle Eastern Crescent and sub-Saharan Africa are communicable, maternal, and perinatal diseases more important than noncommunicable diseases. • There are some startling mismatches between the burden of disease by cause and international efforts in research and health policy analysis: many of the causes of disease burden in developing countries receive grossly disproportionate attention in international public health forums.
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From page 46... ...
to health sectors in developing countries in 1990 amounted to $4,800 million, 82 percent of which came from public coffers in developed countries and 18 percent of which came from private households of those countries. • Of those resources 40 percent flowed through bilateral agencies, 33 percent through United Nations agencies, 8 percent through the World Bank and regional development banks, 17 percent through nongovernmental organizations, 1.5 percent through foundations.
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From page 47... ...
as a metric, the best funded -- leprosy, onchocerciasis, other tropical diseases, sexually transmitted diseases and human immunodeficiency virus infection, and blinding conditions -- get around $4 per DALY; the immunizable diseases, malaria, and trachoma get a little over $1. Acute respiratory infections, which produce by far the largest DALY burden in the developing world, get $0.015 per DALY and noncommunicable diseases and injuries, which produce 50 percent of the disease burden in developing countries, get less than $0.05 per DALY.
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From page 48... ...
RECOMMENDATIONS FOR POLICY AND ACTION 1. The mismatch between international efforts in research and policy analysis and the individual causes of the burden of disease suggest that it is time to review the international health research system, attending carefully to the relationships between disease burden and the current availability of cost-effective interventions.
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From page 49... ...
Students of health systems will lack an empirical basis for making judgments on which policies work and which do not in developing and developed countries, including the United States. Reliable information on global and regional mortality and disability by cause are essential to managing health sector activities; determining financial and human resource allocations; balancing apportionments of all resources among different categories of disease; and deciding on the levels, types, and focus of research activities.
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From page 50... ...
The analysis of changes in distributions of global health expenditures and flows of external assistance to the health sectors in developing countries raises large and challenging questions, especially when the relative volumes of those expenditures are poised against the structure of the global burden of disease. For example, given its small size relative to overall health expenditures in developing countries, what is the appropriate role for external assistance and how can that role be maximized realistically, respectfully, and usefully?
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