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Health economics, Applied econometrics, Epidemiological and economic simulation modeling, Impact evaluation, AIDS.
Mead Over is a senior fellow at the Center for Global Development researching economics of efficient, effective, and cost-effective health interventions in developing countries. Much of his work since 1987, first at the World Bank and now at the CGD, is on the economics of the AIDS epidemic. After work on the economic impact of the AIDS epidemic and on cost-effective interventions, he co-authored the Bank’s first comprehensive treatment of the economics of AIDS in the book, Confronting AIDS: Public Priorities for a Global Epidemic(1997,1999). His most recent book is Achieving an AIDS Transition: Preventing Infections to Sustain Treatment (2011)in which he offers options, for donors, recipients, activists and other participants in the fight against HIV, to reverse the trend in the epidemic through better prevention. His previous publications include The Economics of Effective AIDS Treatment: Evaluating Policy Options for Thailand (2006). Other papers examine the economics of preventing and of treating malaria. In addition to ongoing work on the determinants of adherence to AIDS treatment in poor countries, he is working on optimal pricing of health care services at the periphery, on the measurement and explanation of the efficiency of health service delivery in poor countries and on optimal interventions to control a global influenza pandemic.
In addition to his numerous research projects at the Center, Over currently serves as a member of PEPFAR’s Scientific Advisory Board and as a member of the Steering Committee of the HIV/AIDS modeling consortium funded by the Bill & Melinda Gates Foundation.
Recruited to the World Bank as a Health Economist in 1986, Mead Over advanced to the position of Lead Health Economist in the Development Research Group, before leaving the World Bank to join the Center for Global Development in 2006. Each spring since 2005, he has taught a module on “Modeling the Cost-Effectiveness of Interventions against Infectious Diseases” as part of the master’s degree program in health economics for developing countries at the Centre d'Etudes et de Recherches sur le Développement International (CERDI) at the University of the Auvergne, Clermont-Ferrand, France.
"Evaluating the Impact of Organizational Reforms in Hospitals," with Naoko Watanabe, Chapter 3 in A. Preker and A.Harding (eds.) Innovations in health service delivery: The corporatization of public hospitals. World Bank, March 2003
It’s too early to know how large the economic impact of Ebola will be on West Africa and the world. Past experience, including the 2002-03 Severe Acute Respiratory Syndrome (SARS) epidemic, suggest it could be very large indeed, especially in the African countries that have been hardest hit. Fortunately, actions that the US and other donor countries take now could help not only to control the epidemic but also to minimize the economic fallout.
CGD and its health team express our condolences to the families of all lost on MH17. We know that many of those attending the International AIDS Conference, which starts this week-end in Melbourne, have been touched personally by the AIDS researchers and activists lost on the plane and will deeply feel their loss.
There’s no doubt that Treatment as Prevention (TasP) will receive continued emphasis at this year’s International Aids Conference (IAC), as advocates argue for aggressively expanding treatment from the 9 million worldwide currently on antiretrovirals (ARVs) to the 35 million people who are HIV infected. But at the TasP workshop in Vancouver last month the more challenging and novel topic was pre-exposure prophylaxis, or PrEP. A whole array of sessions on PrEP is already on the agenda for next week’s conference in Melbourne, and our bet is that PrEP will generate a lot of buzz – an approach with intriguing potential, but edgy downside possibilities.
A health policy decision is only as good as the information available to the decision maker. As countries strive to achieve Universal Health Coverage and funding from local governments and global donors is scrutinized, there is an acute need for more and better economic evaluation to inform government and donor investments in healthcare. To that end, the Bill and Melinda Gates Foundation, one of the largest funders of health economic evaluation in LMIC settings, has partnered with an international collaboration of experts to develop the Gates Reference Case – a principle-based standardised methodology for good practice in the planning, implementation, and reporting of economic evaluation for informing priority setting in health. This session will introduce the principles of the Gates Reference Case, explain how and why the reference case was developed, and what this might mean for the conduct and use of economic evaluation and decision-making in LMIC.
The Gates-RC is an element of the International Decision Support Initiative (iDSI), a platform supported by the UK’s Department for International Development, BMGF, and the Rockefeller Foundation, for engaging with and responding to the growing demand for evidence-informed decision-making processes. iDSI involves a partnership between an increasing number of institutions around the world, including NICE international and the Center for Global Development.
Earlier this month, Ambassador Goosby officially announced that he was stepping down from his role as Global AIDS Coordinator where he led the President’s Emergency Plan for AIDS Relief for the past four years. As my colleague Amanda blogged in anticipation of Dr. Goosby’s departure, his service will be remembered for strengthening the evidence base behind PEPFAR’s work.
I recently proposed that any assessment of a country’s statistical capacity be structured around the functions of government, such as those offered by the UN statistical office here. When this list is fully expanded, it includes all of the data that advanced countries like the US or Japan use to manage government and inform citizens. Most developing countries will fall below such an ambitious standard. So how should investments in improved statistical capacity be prioritized?
On World AIDS Day in 2003, WHO and UNAIDS launched a campaign called the “3 by 5 initiative,” with the objective to “treat three million people with HIV by 2005.” At that time, AIDS treatment was still prohibitively expensive for poor countries, where only a few thousand people had access to treatment. Thanks to President Bush’s creation of the President's Emergency Plan for AIDS Relief (PEPFAR) program that same year, the number of people on antiretroviral therapy (ART) began to rise dramatically. While the total number of people on ART reached only one million in 2005, the objective to reach three million people was attained in 2007, and the numbers have continued to climb. The numbers have now surpassed 11 million in low- and middle-income countries and 13 million worldwide. (See bottom trend line in figure 1.)
Recognizing the donors’ obligation to sustain financing for the millions of AIDS patient who would not be alive today without it, this essay proposes a dynamic paradigm for the struggle with the AIDS epidemic—“the AIDS transition” —and argues that to most rapidly achieve an AIDS transition new funding of AIDS treatment should be tightly linked to dramatically improved and transparently measured prevention of HIV infections.
Without PEPFAR, it’s safe to say that almost all of Africa would be stuck near zero HIV treatment coverage. Instead, 49 percent of HIV-infected people were receiving life-saving treatment in 2014, rising to 56 percent by 2015, and the top-performing countries are still gaining ground. This dramatic increase in treatment coverage is a prodigious achievement—and the United States deserves most of the credit. But despite these accomplishments, much more work is needed to reach the end of the epidemic.