Helping poorer countries make locally informed health decisions
Kalipso Chalkidou, director1, Ruth Levine, vice president for programmes and operations2, Andrew Dillon, chief executive3
1 NICE International, National Institute for Health and Clinical Excellence, London
2 Centre for Global Development, Washington, DC USA,
3 National Institute for Health and Clinical Excellence, London
Published 16 July 2010, doi:10.1136/bmj.c3651 - BMJ 2010;341:c3651
Available online at: http://www.bmj.com/cgi/content/full/341/jul16_1/c3651
….Health spending in low income countries is too often driven by outside pressure rather than local evidence. ….
“…….With more money available for health in poorer countries, as well as increasing demand for services and new products, policy makers are looking for ways to expand access, reduce out of pocket spending, and improve outcomes without bankrupting national budgets.
Decisions are still largely driven by historical norms, the priorities of foreign donors, and lobbying pressures, and it is uncommon for countries to have functional mechanisms for making decisions based on their own needs. However, demand is growing from foreign governments and funding agencies to give countries technical and strategic support to develop the capability to make decisions based on local evidence and values.
The National Institute for Health and Clinical Excellence (NICE) has been working in partnership with national governments to strengthen local decision making. We use this experience to suggest ways in which decision makers can be empowered locally…….”
“……The challenge facing governments, global institutions, and funders is how to convert knowledge, experience, funding, and enthusiasm into real and sustained change. This requires at least three things: local data, local technical expertise, and local institutions. …..”
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