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2015 has been the year we have been reminded that there have been major gains in development in many parts of the world, but that hundreds of millions of people still suffer the dangerous consequences of poverty, including high levels of maternal and infant mortality, hunger, illness caused by lack of basic sanitation, and death from easily treatable diseases. How can we improve health systems to make them more effective, as well as less wasteful and more accountable? 

One way, CGD experts Amanda Glassman and Anit Mukherjee tell me in this podcast, is to focus on how health budgets in developing countries are spent. It is often administrations at the local level – regional, state – that make spending decisions, while health priorities are often set by national governments, who distribute tax revenues that pay for health programs. Glassman and Mukherjee have coauthored – along with other members of the working group – a new CGD report on how to close the gap between fiscal policy and health policy for more effective and efficient health services. 

“It’s really important for us to understand the connection between money, services provided, and health outcomes,” Glassman says. 

It’s particularly important in countries like India, where state populations surpass those of small countries. “We should be having a much more differentiated approach to how those states want to prioritize their expenditure,” Mukherjee says, “and how they can use the money for better outcomes.”

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CGD blog posts reflect the views of the authors drawing on prior research and experience in their areas of expertise. CGD does not take institutional positions.