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1.
Lancet ; 398(10308): 1317-1343, 2021 10 09.
Article in English | MEDLINE | ID: covidwho-2184616

ABSTRACT

BACKGROUND: The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. METHODS: We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. FINDINGS: In 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7-8·8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40·4 billion (0·5%, 95% UI 0·5-0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0-25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this, $13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and $1·4 billion was repurposed from existing health projects. $3·1 billion (22·4%) of the funds focused on country-level coordination and $2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34·3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. INTERPRETATION: Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. FUNDING: Bill & Melinda Gates Foundation.


Subject(s)
COVID-19/prevention & control , Developing Countries/economics , Economic Development , Healthcare Financing , International Agencies/economics , COVID-19/economics , COVID-19/epidemiology , Financing, Government/economics , Financing, Government/organization & administration , Global Health/economics , Government Programs/economics , Government Programs/organization & administration , Government Programs/statistics & numerical data , Government Programs/trends , Gross Domestic Product , Health Expenditures/statistics & numerical data , Health Expenditures/trends , Humans , International Agencies/organization & administration , International Cooperation
2.
BMJ ; 379: o2514, 2022 10 19.
Article in English | MEDLINE | ID: covidwho-2088790
3.
Lancet Infect Dis ; 22(10): 1406-1407, 2022 10.
Article in English | MEDLINE | ID: covidwho-2036641
4.
Environ Manage ; 70(5): 697-709, 2022 11.
Article in English | MEDLINE | ID: covidwho-2007132

ABSTRACT

The resilience of public environmental agencies is an important but broadly under-researched discourse. This paper addresses this lacuna by drawing on a three-part typology of resilience from organizational studies and applying it to the English natural environment agency, Natural England, following a decade of public sector agency de-funding under the aegis of austerity. The research question was explored qualitatively through eleven semi-structured interviews with the senior management team of Natural England during the summer of 2020. The findings suggest that public agency multi-functionality equate to heterogenous resilience across agency functions; that generally agency resilience (as a function of capacities) is poor with consequences upon good governance; and that they are broadly poorly positioned for the aftermath of Covid-19. The findings speak directly to the regulatory and organizational literatures with public administration by evidencing the complex realities of understanding resiliencies in large multi-functional public environmental agencies.


Subject(s)
Environment , Organizational Culture , Public Sector , Financial Support , Financing, Government , Humans
5.
East Mediterr Health J ; 26(5): 492-494, 2020 May 21.
Article in English | MEDLINE | ID: covidwho-2002915

ABSTRACT

The coronavirus disease 2019 (COVID-19) outbreak that began in Wuhan, Hubei Province, China in late 2019 has spread globally within a few months. The Director General of the World Health Organization (WHO) declared the COVID-19 outbreak to be a public health emergency of international concern (PHEIC) after the second meeting of the IHR (2005) Emergency Committee on 30 January 2020. On 12 March 2020, the outbreak of COVID-19 was characterized as a pandemic.


Subject(s)
Communicable Disease Control/methods , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Betacoronavirus , COVID-19 , Clinical Trials as Topic , Communicable Disease Control/economics , Congresses as Topic , Disease Outbreaks , Financing, Government , Humans , Mediterranean Region/epidemiology , Pandemics , Pneumonia, Viral , SARS-CoV-2 , World Health Organization
6.
Appl Health Econ Health Policy ; 20(5): 681-691, 2022 09.
Article in English | MEDLINE | ID: covidwho-1966202

ABSTRACT

OBJECTIVE: Easy and equitable access to testing has been a cornerstone of the public health response to COVID-19. Currently in Australia, testing using polymerase chain reaction (PCR) tests for COVID-19 is free to the user, but government funding for rapid antigen tests (RATs) is limited. We conduct an economic analysis of alternative government policies regarding the funding of COVID-19 testing in Australia. METHODS: A decision tree model was developed to describe COVID-19 testing pathways for the Australian population over a 1-week period. The model outputs were analysed to estimate R numbers associated with alternative funding policies, which were used to estimate COVID-19 cases over a 6-month time horizon. Healthcare costs and quality-adjusted life-year (QALY) effects were applied to new COVID-19 cases. The model was populated using responses to a de novo population survey and published data sources. RESULTS: Compared with no government-funded COVID-19 testing, government-funded testing is estimated to generate large incremental net monetary benefits (INMBs), up to A$15 billion in the base-case analyses. Government-funded PCR testing and RATs for all is predicted to maximise INMBs in most tested scenarios, though funding RATs for all and not PCR tests has similar INMBs in many scenarios and generates higher benefits to costs ratios. CONCLUSIONS: Our interpretation of the modelled analysis is that at the time of writing (July 2022), with high vaccination uptake in Australia and few other public health measures in place, Australian governments should consider reducing funding of PCR testing, for example, limiting capacity to essential workers and individuals with known risk factors for serious symptoms, and fund RATs for all.


Subject(s)
COVID-19 Testing , COVID-19 , Financing, Government , Australia , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing/economics , Cost-Benefit Analysis , Humans
7.
Nurs Sci Q ; 35(3): 291-294, 2022 07.
Article in English | MEDLINE | ID: covidwho-1932984

ABSTRACT

This column concerns the power of an RO1 grant from the federal government of the United States. To that end, a discussion of the philosophical viewpoints of power, the process of applying for federal grants, and a consideration of a more inclusive process will ensue.


Subject(s)
Financing, Government , Humans , United States
9.
Glob Health Action ; 15(1): 2072461, 2022 12 31.
Article in English | MEDLINE | ID: covidwho-1900942

ABSTRACT

Debt burdens are growing steadily in Low- and Middle-Income Countries (LMICs), compounded by the COVID-19 economic recession, threatening to crowd out essential health spending. In 2019, 54 LMICs spent more on servicing their debt to foreign creditors than on financing their health services. While development loans may have positive effects on population health, the ensuing debt servicing requirements may have detrimental effects on health through constrained fiscal space for government health spending. However, the existing evidence is inadequate for an understanding of whether, and if so how and under what circumstances, debt may constrain government health spending. We call for more research on the impacts of debt on health financing and call on creditors and borrowers to carefully consider the potential impacts of lending on borrower countries' ability to finance their health services.


Subject(s)
COVID-19 , Healthcare Financing , COVID-19/epidemiology , Developing Countries , Financing, Government , Health Services , Humans , Income
12.
BMJ ; 377: o1216, 2022 05 16.
Article in English | MEDLINE | ID: covidwho-1854308
15.
BMJ ; 377: o984, 2022 04 14.
Article in English | MEDLINE | ID: covidwho-1788950
16.
Int J Environ Res Public Health ; 19(6)2022 03 17.
Article in English | MEDLINE | ID: covidwho-1760591

ABSTRACT

To facilitate the green transformation of enterprises and realize low-carbon development, governments have adopted the policies of carbon emission constraint and carbon trade to promote enterprises' low-carbon production. Although the two policies aim to reduce carbon emissions, they have different effects on enterprises' production. Meanwhile, the development of remanufacturing caters to the low-carbon economy. Therefore, this article establishes the game models between an original equipment manufacturer (OEM) and a remanufacturer under carbon-emission-constraint and carbon-trade policies, analyzing the production decisions of enterprises under different policies to compare the influence of the two policies on outsourcing remanufacturing. The main conclusions of the article are as follows: (1) Both carbon-emission-constraint and carbon-trade policies increase the unit retail price of remanufactured and new products, reducing the new products sales volume. However, the sales volume of remanufactured products only decreases if the discount rate is less than the rate of carbon emissions of the two products. (2) The upper limit of carbon emissions can affect the unit outsourcing cost. The unit cost of outsourcing under the carbon-emission-constraint policy is only higher when the upper limit of carbon emissions is less than a certain threshold, and the discount rate is larger than the proportion of carbon emissions for both products; otherwise, the unit outsourcing cost under the carbon-trade policy is higher. (3) Both policies lessen the total environmental implication. When the upper limit of carbon emissions is less than a particular threshold, the environmental effect of the two manufacturers under the carbon-emission-constraint policy is smaller; otherwise, the environmental impact is smaller under the carbon-trade policy.


Subject(s)
Outsourced Services , Carbon , Commerce , Financing, Government , Policy
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