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Rachel Silverman is a senior policy analyst and assistant director of global health policy at the Center for Global Development, focusing on global health financing and incentive structures. During previous work at the Center from 2011 to 2013, she contributed to research and analysis on value for money, incentives, measurement, and policy coherence in global health, among other topics. Before joining CGD, Silverman spent two years supporting democratic strengthening and good governance programs in Kosovo and throughout Central and Eastern Europe with the National Democratic Institute. She holds a master's of philosophy with distinction in public health from the University of Cambridge, which she attended as a Gates Cambridge Scholar. She also holds a BA with distinction in international relations and economics from Stanford University.
In recent years, the interdisciplinary nature of global health has blurred the lines between medicine and social science. As medical journals publish non-experimental research articles on social policies or macro-level interventions, controversies have arisen when social scientists have criticized the rigor and quality of medical journal articles.
More than ever, global health funding agencies must get better value for money from their investment portfolios; to do so, each agency must know the interventions it supports and the sub-populations targeted by those interventions in each country. In this study we examine the interventions supported by two major international AIDS funders: the Global Fund to Fight AIDS, Tuberculosis, and Malaria (‘Global Fund’) and the President’s Emergency Plan for AIDS Relief (PEPFAR).
Break out the firecrackers and balloons – and water and soap: today is Global Handwashing Day! And while today's significance may get lost in the very busy calendar of Global Health "holidays", this one really does deserve special celebration.
This report offers a strategy for the Global Fund to get more health for the money by focusing more on results, maximizing cost-effectiveness, and systematically measuring performance throughout its operations.
Performance-based financing can be used by global-health funding agencies to improve program performance and thus value for money. The Global Fund to Fight AIDS, Tuberculosis and Malaria was one of the first global-health funders to deploy a performance-based financing system. However, its complex, multistep system for calculating and paying on grant ratings has several components that are subjective and discretionary. We aimed to test the association between grant ratings and disbursements, an indication of the extent to which incentives for performance are transmitted to grant recipients.
This week, representatives from 50-plus countries gathered in Brussels for the “She Decides” conference, raising about $190 million in pledges to support women’s reproductive and sexual health and rights around the world. This is great news, but the relatively small absolute scale of the pledges highlights the challenge of substituting for US financial and political leadership.
As the largest bilateral donor in global health, the President’s Emergency Plan for AIDS Relief (PEPFAR) is unequaled in its reach and impact. Yet despite its larger-than-life profile, we’ve found that the details of its implementation arrangements and decision-making often remains obscure to the longstanding chagrin of globalhealthobservers. Among the common questions: Where does scarce PEPFAR funding go? Which countries and implementers receive the bulk of PEPFAR funds? And what factors influence PEPFAR’s allocation of resources across recipient countries?
Navigating the global health funding landscape can be confusing even for global health veterans; there are scores of donors and multilateral funding mechanisms, each with its own particular structure, personality, and philosophy. For the uninitiated, PEPFAR, GAVI, PMI, WHO, the Global Fund, UNITAID, and the Gates Foundation can all appear obscure and intimidating. But if your head is spinning from acronym-induced vertigo, fear not! We are here to help you make sense of it all. How, you ask? With a clear method for donor identification: comparing the donors to your parents.
The new US administration may put US funding for family planning—comprising nearly half of all bilateral contributions—at risk. The family planning community still has time to make the case for sustained US funding, protecting the gains that it has already achieved. But smart advocacy should also be accompanied by contingency planning—what would it mean for the United States (US) to substantially cut its support?
Last week, I attended a conference on South Africa’s national health insurance (NHI), which was hosted in Pretoria by the Human Sciences Research Council (HSRC). A key recurring theme and consensus emerged: South Africa must develop a clearer plan and strategy for the “piloting” phase of its national health insurance.
Some background: In 2011, the government of South Africa committed itself to providing all of its citizens with “a defined package of comprehensive (health) services” through national health insurance. While the details are still up in the air, the government issued a preliminary policy paper which estimated NHI to cost R255 billion (~US$30 billion) per year by 2025, if implemented as planned over a 14-year period.
The Global Fund’s Office of the Inspector General (OIG) released a new audit report on Wambo.org, its online procurement platform for drugs and other health commodities. The headline: despite high marks from its users, Wambo.org is not yet on track to deliver the projected savings. But more than the headline, a close read of the report narrative helps us understand why reality does not yet reflect the Global Fund’s optimistic assumptions—and, reading between the lines, suggests three important lessons for the Global Fund and other international funders