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2. Indian State Priorities for Health Innovation Partnerships
- Author:
- Nicole Davis, Christa Twyford Gibson, and Jonathan Gonzalez-Smith
- Publication Date:
- 03-2019
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- Many international institutions—universities, foundations, companies, NGOs, and governments—would like to engage more deeply with the government of India to improve health outcomes. However, a lack of transparency, changing state-level priorities, and the absence of a single venue to learn about engagement opportunities holds back many potential partnerships. The Center for Strategic and International Studies (CSIS) Wadhwani Chair in U.S.-India Policy Studies and Duke University’s Innovations in Healthcare have launched the “Indian States Health Innovation Partnership” to address this information gap and encourage subnational health care cooperation between Indian government entities and external partners. The primary goal of this project is to strengthen health outcomes in India by methodically identifying which Indian states are ripe for innovative partnerships with international institutions and broadcasting these opportunities publicly to spur future partnerships. In the first phase of this project, the team developed a clearer picture of India’s state-level health care reform priorities and identified specific areas for potential partnership across four categories: capacity building, organizational delivery, financing, and specific health conditions.
- Topic:
- Health, Governance, Health Care Policy, Innovation, and Public Health
- Political Geography:
- India and Asia
3. Harnessing Multilateral Financing for Health Security Preparedness
- Author:
- Center for Strategic and International Studies
- Publication Date:
- 04-2019
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- The economic consequences of large-scale disease outbreaks can be enormous: pandemics could cause $570 billion per year in average economic losses over the coming decades. Health security threats have an especially destructive impact on development investments and GDP in low-income and lower-middle-income countries (LICs and LMICs): the 2014-2015 Ebola outbreak in West Africa wiped out nearly five years of existing investments in the region, gravely setting back the region’s future development prospects. By contrast, upgrading countries’ preparedness is relatively inexpensive and affordable; recent data demonstrates most countries would need to spend approximately $0.50-$1.50 per person per year to get an acceptable level of epidemic preparedness. The financing gap for preparedness is one of the starkest problems in health security, especially among LICs and LMICs. That gap is estimated at $4.5 billion per year. Investments in preparedness are cost-effective and affordable, but low-income and lower-middle-income country governments continue to underinvest at dangerously low levels. These governments bear lead responsibility for addressing financing gaps, but external funding can be catalytic. At present, there is no financing mechanism and no adequate incentive structure to motivate governments in high-risk countries to invest in preparedness, particularly when those investments compete with more visible priorities such as education, housing, transport infrastructure, and other pressing health needs. As a consequence, countries remain ill-prepared and vulnerable to the persistent threat of pandemics and large-scale disease outbreaks. The World Bank Group’s International Development Association (IDA) replenishment takes place every three years and presents a choice opportunity to make adjustments that reflect important emerging priorities. In the current IDA19 replenishment, stakeholders can take a major step towards closing the preparedness financing gap by incentivizing $1 billion or more per year in preparedness investments in LICs and LMICs.
- Topic:
- Security, Health, Multilateralism, and Public Health
- Political Geography:
- North America and United States of America
4. The U.S. Department of Defense’s Role in Health Security
- Author:
- Tom Cullison and J. Stephen Morrison
- Publication Date:
- 06-2019
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- Protecting the homeland against biological threats begins with preventing those threats from reaching our shores. The Department of Defense (DOD) contributes to overall U.S. health security through programs specifically aimed at countering biological threats from all sources—through public health activities coordinated with civilian counterparts at home and abroad and through research and development of medical countermeasures aimed at protecting U.S. Forces against health risks throughout the world. Civilian and military scientists, public health experts, and disaster planners are somewhat familiar with DOD’s health security capabilities, yet most lack a clear understanding of the breadth, depth, and limitations of DOD’s capacities. A solid and consistent U.S. policy framework has steadily evolved over the past few decades that identifies health as a national security issue and calls for a broad-based, inclusive national response to addressing the issue of health security. Now is the time to more fully integrate DOD’s unique expertise and capabilities in a more cohesive and efficient manner. This paper provides a broad overview of DOD health security activities and capabilities and also offers select concrete recommendations for strengthening the coherence and integration of DOD activities, with a special emphasis on leadership, novel diseases and new dangerous forms of resistance, surveillance, building host country capacities, and expanded exercises.
- Topic:
- Security, Defense Policy, Health, and Civil-Military Relations
- Political Geography:
- North America and United States of America
5. Engaging India: Guide to Developing Health Care Partnerships with States
- Author:
- Nicole Davis, Christa Twyford Gibson, and Jonathan Gonzalez-Smith
- Publication Date:
- 08-2019
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- Indian states control most facets of healthcare delivery. Every state has a different set of healthcare delivery gaps and priorities. Understanding these gaps can help foreign institutions target cooperation more effectively- going to the right place with the right type of cooperation. But having a base for cooperation must be paired with an effective strategy to engage India's states. Issues such as states' political timelines, shifts in key bureaucrats, and other issues can have a major impact on potential projects. In this report, Innovations in Healthcare and CSIS lay out strategies employed by a range of international institutions with current subnational partnerships in India.
- Topic:
- Health, Governance, Health Care Policy, and Innovation
- Political Geography:
- India and Asia
6. Federal Funding for Biosafety Research Is Critically Needed
- Author:
- Rocco Casagrande
- Publication Date:
- 08-2019
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- The advent of powerful new tools in biotechnology promises to open a new era in the battle against infectious disease. This research will undoubtedly lead to better capability to predict and prevent global outbreaks, and will support the development of new vaccines and treatments to reduce the burden of outbreaks we cannot prevent. The benefits afforded by these powerful tools are not without attendant risks. The threat of biological laboratory accidents is not commonly understood to be a serious health security concern similar in significance to the threats of emerging infectious diseases and biological attacks. However, scientists are just now creating viruses that exceed the transmissibility or pathogenicity of naturally occurring strains. Also contributing to the rising risk of accidents is the entry into the life sciences of scientists from other fields and hobbyists, who may be accustomed to weaker accountability measures, enjoy less training and weaker knowledge of safety and consequences of accidents, and yet are drawn to the tools of biology because of the expansive power they afford. Unlike accidents in transportation, chemical production, or even nuclear power, biosafety accidents can result in the unforeseen and uncontrolled infection of lab personnel or their local communities, the release of a pathogen into the environment, or even the initiation of a global pandemic that could reach millions. There is abundant concern among health security experts and U.S. policymakers over the threat of pathogens being deliberately released into communities by malevolent actors and terrorist attacks. While these concerns are valid, we are not paying enough attention to the costly and real risks of biological laboratory accidents that threaten similarly dangerous outcomes. The United States is underinvesting in the science of biosafety. The resulting lack of data and active research in the field leaves the biosafety community with little understanding of how accidents are likely to occur and impedes the identification of cost- effective measures to prevent accidents. This gap in knowledge could be addressed with a modest budget of $10 million per year given to the National Institute of Occupational Safety and Health to fund a dedicated U.S. biosafety research program. The funding is modest because the first step is to develop a research community that focuses on these issues; currently, the lack of funding has prevented focused attention on research in biosafety. With adequate funding, this research will lead to the development of cost-effective training programs to reduce human error in the laboratory, the redesign of risky experiments to prevent outbreaks before they occur, and the identification of cost-effective investments in laboratory safety equipment, which could make the conduct of life sciences research more efficient.
- Topic:
- Health, Science and Technology, Biosecurity, and Medicine
- Political Geography:
- North America and United States of America
7. Putin and Global Health: Friend or Foe?
- Author:
- J. Stephen Morrison and Judyth L. Twigg
- Publication Date:
- 09-2019
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- Over the course of this decade, Russia has consciously enlarged its engagement and commitments, at home and in the wider world, in battling both tuberculosis (TB) and non-communicable diseases (NCDs). Despite these positive steps, Russia remains a serious global health security threat. There is a live risk of uncontrolled HIV/AIDS and drug-resistant tuberculosis (DR-TB) epidemics within Russia itself, as well as ongoing risk of export to neighbors in Eastern Europe and Central Asia, whose deep interdependence with Russia, including extensive migrant traffic, creates acute vulnerabilities. Beyond Eurasia, Russia stands out as one of several flashpoints in the world that could contribute to a resurgent HIV/AIDS and DR-TB epidemic that reverses the global gains of the past 15 years. Russia’s social media practices deliberately spread confusion and distrust surrounding a wide range of preventive health measures, ranging from vaccines to harm reduction. This analysis weighs Russia’s positive contributions against its multiple destructive actions in global health, examines what the overall pattern of Russian behavior means for U.S. policy, and concludes with a proposal for an expanded U.S. health security alliance with Eastern Europe and Central Asia. It argues that the United States should welcome Russian contributions and collaborate with serious Russian partners in the service of broader shared health goals. At the end of the day, however, Russia will only earn a legitimate global health leadership seat through progressive, evidence-based policies and actions, which can never be wholly segregated from the noise created by its geopolitically destabilizing actions.
- Topic:
- Health, International Cooperation, Public Health, and Pandemic
- Political Geography:
- Russia, Europe, North America, and United States of America
8. Venezuela’s Crisis Is Now a Regional Humanitarian Disaster
- Author:
- Moises Rendon and Mark L Schneider
- Publication Date:
- 03-2018
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- The Issue Venezuela has been subjected to an unprecedented man-made humanitarian crisis, including extreme food and medicine shortages, thousands of children dying of malnutrition, and malnourished people contracting formerly eradicated diseases. While Venezuela’s dictatorial regime has repeatedly rejected humanitarian aid from the outside, the country’s humanitarian, economic, social, and institutional collapse, along with fierce political repression, have caused 1.2 million Venezuelans to flee the country over the past two years, with hundreds of thousands more and possibly millions expected to flee in the future. Our Recommendations Encourage the United States and other like-minded countries to provide leadership on the diplomatic and assistance fronts to help respond to this crisis. Work to build consensus within the international community on the urgency of the Venezuelan humanitarian crisis and to agree on steps to address the crisis, including convening a high-level task force. Develop a comprehensive policy response that includes immediate relief efforts on Venezuela’s border with Colombia and within Venezuela using innovative mechanisms due to the current limited humanitarian access. Provide immediate technical assistance to help estimate the level of need and identify available resources. Support and engage civil society and local actors, including nongovernmental organizations (NGOs), the private sector, and entrepreneurs, as well as the Venezuelan diaspora community, to help limit the suffering of the Venezuelan people. Encourage host countries to grant temporary protected status to Venezuelans and create a broader burden-sharing arrangement in the region for processing those seeking refuge, following the recent guidelines by the UN High Commissioner for Refugees (UNHCR). Support the use of innovative technology tools, such as blockchain and digital currencies, to facilitate distribution of aid within and beyond Venezuela.
- Topic:
- Health, Poverty, United Nations, Food, and Humanitarian Crisis
- Political Geography:
- United States, South America, and Venezuela
9. U.S. Actions Can Help Keep Global Polio Eradication Strategy on Track
- Author:
- Nellie Bristol
- Publication Date:
- 07-2015
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- The Global Polio Eradication Initiative (GPEI) in April 2013 unveiled an ambitious six-year strategy aimed at finally ending polio worldwide. The four-pronged approach called for stopping transmission in the remaining polio endemic countries while also eliminating rare but paralyzing vaccine-related polio. It outlined plans to ensure proper laboratory and health facility containment of poliovirus as eradication neared. Lastly, the Polio Eradication & Endgame Strategic Plan 2013–2018 urged countries, donors, and international partners to begin planning for the transition of polio program resources to country heath systems and other health initiatives. The drive to eradicate polio is at a pivotal point. The number of cases is down globally compared to last year. Polio programs in both Nigeria and Pakistan are moving in a positive direction while progress in Afghanistan is holding steady. A successful move to bivalent OPV would greatly reduce the number of polio cases caused by vaccine viruses and set the stage for an eventual worldwide switch to IPV. But extraordinary efforts still are required to reach the endgame strategy’s goals.
- Topic:
- Health, Infectious Diseases, and Health Care Policy
10. Counting the Cost of South Africa's Health Burden
- Author:
- Richard Downie and Sahil Angelo
- Publication Date:
- 07-2015
- Content Type:
- Working Paper
- Institution:
- Center for Strategic and International Studies
- Abstract:
- South Africa’s health system is approaching a make or break moment. Can it complete a set of complex organizational reforms and place itself on a sustainable financial footing that will enable it to deliver first-rate health care services to patients? Or will a stalled political process, economic stagnation, and the country’s daunting—and expanding—health burden torpedo the reform effort and cause the system to grind to a halt, with dire consequences for the nation’s health? CSIS explored these questions on a recent research trip to South Africa. This report summarizes the findings
- Topic:
- Health and Health Care Policy
- Political Geography:
- South Africa