Ideas to Action:

Independent research for global prosperity

Publications

 

February 27, 2016

Designing Contracts for the Global Fund: Lessons from the Theory of Incentives - Working Paper 425

This paper uses contract theory to suggest simple contract designs that could be used by the Global Fund. Using a basic model of procurement, we lay out five alternative options and consider when each is likely to be most appropriate. We ultimately provide a synthesis to guide policy makers as to when and how 'results-based' incentive contracts can be used in practice.

February 26, 2016

Global Health Donors Viewed as Regulators of Monopolistic Service Providers: Lessons from Regulatory Literature - Working Paper 424

Controlling healthcare costs while promoting maximum health impact in the recipient countries is one the biggest challenges for global health donors. This paper views global health donors as the regulators of monopolistic service providers, and explores potential optimal fund payment systems under asymmetric information. It provides a summary and assessment of optimal price regulation designs for monopolistic service providers.

December 15, 2015

Aligning Incentives, Accelerating Impact: Next Generation Financing Models for Global Health

Founded in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is one of the world’s largest multilateral health funders, disbursing $3–$4 billion a year across 100-plus countries. Many of these countries rely on Global Fund monies to finance their respective disease responses—and for their citizens, the efficient and effective use of Global Fund monies can be the difference between life and death.

July 20, 2015

Strengthening Incentives for a Sustainable Response to AIDS: A PEPFAR for the AIDS Transition

Remarkable progress has been made in the global fight against HIV/AIDS. The number of people receiving treatment in low- and middle-income countries increased from 300,000 in 2003 to 13.7 million in 2015, including 7 million supported by the United States. These gains are primarily attributable to a 2003 US government initiative called PEPFAR (the President’s Emergency Plan for AIDS Relief) that provided major new multiyear funding for global HIV/AIDS and created a new entity, the Office of the Global AIDS Coordinator, headed by an ambassador-rank Global AIDS Coordinator who is authorized to allocate PEPFAR’s resources and coordinate all US bilateral and multilateral activities on HIV/AIDS.

However, without dramatic changes to PEPFAR, the next president risks being held responsible for the failure of a program that until now has been one of the United States’ proudest foreign assistance achievements. And because PEPFAR is a major component of US foreign assistance spending, the next president’s choices about PEPFAR will heavily influence any subsequent assessments of his or her humanitarian foreign assistance policies.

The Cost and Cost-Effectiveness of Alternative Strategies to Expand Treatment to HIV-Positive South Africans: Scale Economies and Outreach Costs
April 23, 2015

The Cost and Cost-Effectiveness of Alternative Strategies to Expand Treatment to HIV-Positive South Africans: Scale Economies and Outreach Costs - Working Paper 401

The South African government is currently discussing various alternative approaches to the further expansion of antiretroviral treatment (ART) in public-sector facilities. Alternatives under consideration include the criteria under which a patient would be eligible for free care, the level of coverage with testing and care, how much of the care will be delivered in small facilities located closer to the patients, and how to assure linkage to care and subsequent adherence by ART patients.

Gesine Meyer-Rath , Mead Over , Daniel J. Klein and Anna Bershteyn
Cover of Achieving an AIDS Transition: Preventing Infections to Sustain Treatment
August 15, 2011

Achieving an AIDS Transition: Preventing Infections to Sustain Treatment

Five million people in poor countries are receiving AIDS treatment, but international AIDS policy is still in crisis. This book shows how to reach an “AIDS transition,” which would keep AIDS deaths down by sustaining treatment while pushing new infections even lower, so that the total number of people living with HIV/AIDS finally begins to decline.

January 12, 2011

Antiretroviral Therapy Awareness and Risky Sexual Behaviors: Evidence from Mozambique - Working Paper 239

In this paper, the authors set out to study how increased access to antiretroviral therapy affects sexual behavior in Mozambique. The researchers found that greater access to antiretroviral therapy led Mozambicans to perceive HIV/AIDS as less dangerous and to engage in more risky sexual behavior. The authors conclude that prevention programs must include educational messages about antiretroviral therapy in order to temper changing beliefs about HIV.

Damien de Walque , Harounan Kazianga and Mead Over
January 6, 2011

Food Crisis, Household Welfare, and HIV/AIDS Treatment: Evidence from Mozambique - Working Paper 238

Using panel data from Mozambique collected in 2007 and 2008, the authors explore the impact of the food crisis on the welfare of households living with HIV/AIDS. While HIV households have not suffered more from the crisis than others, infected people who experienced a negative income shock also expereinced a reduction or a slower progression in outcomes when treating their illness.

Damien de Walque , Harounan Kazianga , Mead Over and Julia Vaillant
June 1, 2010

Sustaining and Leveraging AIDS Treatment

In the final installation of a three-part series, Mead Over estimates the fiscal burden of international AIDS treatment programs, and suggests ways that donors, governments, and patients can sustain current treatments while preventing future cases.

May 24, 2010

Using Incentives to Prevent HIV Infections

This essay proposes ways to improve the effectiveness of HIV prevention by strengthening incentives for both measurement and achievement. It builds upon a companion essay that proposes an “AIDS Transition”—that is, a gradual reduction in the number of people infected with HIV even as those inflected live longer—as a reasonable objective of donor and government AIDS policy.

May 17, 2010

The Global AIDS Transition: A Feasible Objective for AIDS Policy

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.

February 26, 2009

AIDS Treatment in South Asia: Equity and Efficiency Arguments for Shouldering the Fiscal Burden When Prevalence Rates Are Low - Working Paper 161

Senior fellow Mead Over estimates the effect of AIDS on poverty in South Asia and analyzes public policy options to help the region’s predominantly private health care systems meet the challenge of treating AIDS. He finds that South Asian governments should play a larger role in AIDS treatment than in other aspects of health care, in the interest of both efficiency and equity.

September 5, 2008

Opportunities for Presidential Leadership on AIDS: From an "Emergency Plan" to a Sustainable Policy (White House and the World Policy Brief)

U.S. spending on global AIDS is widely seen as a significant foreign policy and humanitarian success, but this success contains the seeds of a future crisis. Treatment costs are set to escalate dramatically and new HIV infections continue to outpace the number of people receiving treatment. Three bad options thus loom ahead for U.S. foreign policy: indefinitely increase foreign assistance spending on an open-ended commitment, eliminate half of other foreign aid programs, or withdraw the medicine that millions of people depend upon to stay alive. CGD senior fellow Mead Over provides another option: implementing a sustainable policy that concentrates on prevention in order to drastically cut new infections while sustaining the reduction in AIDS-related deaths.

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