Understanding the Economics of Microbial Threats Proceedings of a Workshop (2018) / Chapter Skim
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8 Reimagining Sustainable Investments to Counter Microbial Threats
8 Reimagining Sustainable Investments to Counter Microbial Threats
Pages 87-96
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From page 87... ...
The session featured two presentations: Dean Jamison, professor emeritus in global health at the University of California, San Francisco, presented on the economics of international collective action to control microbial threats, focusing on the landscape of development assistance for country-specific and global health functions. Tania Zulu Holt, partner at McKinsey and Co., discussed economic bottlenecks in delivering medical products across Africa and the role of human-centered costing to ensure supply chain sustainability in resource-limited settings.
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From page 88... ...
Country-Specific Versus Global Functions in International Aid for Health Jamison explained that there are functions of international aid for infectious disease management that can be divided into two categories. One is country-specific functions that strengthen national disease control and health systems, and the other category is global functions that aim to meet global goals, such as those supporting core global public goods (e.g., research and development [R&D]
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From page 89... ...
For example, the majority of donor funds for country-specific functions in low- and middle-income countries are focused on financing health services delivery, whereas in high-income countries they are focused on training health workers from low- and middle-income countries. He added that investments for global functions in low- and middle-income countries assist with national efforts in transnational activities, such as pandemic preparedness.
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From page 90... ...
Shifting aid away from country-specific purposes toward these global function priorities is what Jamison believes economic analyses is increasingly pointing toward as a desirable path. OVERCOMING ECONOMIC BOTTLENECKS IN DELIVERING MEDICAL PRODUCTS TO ADDRESS MICROBIAL THREATS ACROSS AFRICA Tania Zulu Holt, a partner at McKinsey and Co., presented on the realities she has observed on the ground of supply chain bottlenecks in delivering medical products across Africa.
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From page 91... ...
Human-Centered Approach in Costing Medical Product Supply Chains Holt described the high costs typically accounted for in systematic planning of medical product delivery to health facilities, including the costs associated with procurement, warehousing, and delivery. She argued that
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From page 92... ...
B = bi-monthly; Bi = twice per year; CMS = Central Medical Store; DFID = U.K. Department for International Development; GF = The Global Fund to Fight AIDS, Tuberculosis and Malaria; GON = Government of Nigeria; LGA = local government area; M = monthly; NACA = National Agency for the Control of AIDS; NMEP = National Malaria Eradication Program; NSCS = National Strategic Cold Store; PEPFAR = The President's Emergency Plan for AIDS Relief; PMI = President's Malaria Initiative; PW = private warehouse; Q = quarterly; T = three times per year; UNFPA = United Nations Population Fund.
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From page 93... ...
Potential Strategies for Reducing Economic Bottlenecks Holt described four strategies to reduce economic bottlenecks in the medical product supply chain, despite the challenge in distilling the exact costs of integrating supply chains and investing in other potential solutions. Firstly, zero-based budgeting, where all economic costs are reevaluated bottom up and justified for each new time period, can help to better account for human-centered costs and provide a more accurate baseline in countries and remove hidden costs.
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From page 94... ...
Katharina Hauck, senior lecturer at the Imperial College London, observed the scope of the McKinsey analysis of primary health facilities in Nigeria and asked about the methodological challenges of evaluating the cost-effectiveness of health systems strengthening initiatives, particularly
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From page 95... ...
Agency for International Development programs invest in both global functions, such as R&D, with country-specific aims to build local capacity for national pandemic preparedness. Jamison responded that the hybrid program she described was the political "sweet spot" of funds advancing a global public good while actually being spent within countries.
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