International Journal of Health Policy and Management

International Journal of Health Policy and Management

How Should Global Fund Use Value-for-Money Information to Sustain its Investments in Graduating Countries?

Document Type : Debate

Authors
Kitti Kanpirom 1
Alia Cynthia G. Luz 2
Kalipso Chalkidou 3
Yot Teerawattananon 4
1 Bureau of Health Administration, Ministry of Public Health, Nonthaburi, Thailand
2 HITAP International Unit, Ministry of Public Health, Nonthaburi, Thailand
3 Global Health and Development Team, Imperial College London, London, UK
4 Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
10.15171/ijhpm.2017.25
Abstract
It has been debated whether the Global Fund (GF), which is supporting the implementation of programs on the prevention and control of HIV/AIDS, tuberculosis (TB) and malaria, should consider the value-for-money (VFM) for programs/interventions that they are supporting. In this paper, we critically analyze the uses of economic information for GF programs, not only to ensure accountability to their donors but also to support country governments in continuing investment in cost-effective interventions initiated by the GF despite the discontinuation of financial support after graduation. We demonstrate that VFM is not a static property of interventions and may depend on program start-up cost, economies of scales, the improvement of effectiveness and efficiency of providers once the program develops, and acceptance and adherence of the target population. Interventions that are cost-ineffective in the beginning may become cost-effective in later stages. We consider recent GF commitments towards value for money and recommend that the GF supports interventions with proven cost-effectiveness from program initiation as well as interventions that may be cost-effective afterwards. Thus, the GF and country governments should establish mechanisms to monitor cost-effectiveness of interventions invested over time.
Keywords
Value-for-Money (VFM)
Global Fund (GF)
Vertical Programs
Priority Setting
Government Healthcare
Investments
Subjects
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International Journal of Health Policy and Management
Volume 6, Issue 9
2017
Pages 529-533

  • Received Date 27 October 2016
  • Revised Date 17 February 2017
  • Accepted Date 18 February 2017
  • First Published Date 01 September 2017
  • Published Date 01 September 2017