Yes I essentially agree—though the other option available is to decide to work more through local institutions to prioritise and fund health services. Again yes this may be better done at scale. Though with the rate of growth in EA funding, I wouldn’t rule out a role for this kind of EA engagement. Or perhaps there is a role for EA as a kind of catalytic funder, investing in frameworks/platforms for more effective aid policy from states and major multilaterals.
I think you mean that if there are gaps for highly cost-effective services that aren’t being delivered by other donors (or indeed the national health system, we should remember that even in the very poorest countries, national institutions are still likely to be the main healthcare funder and provider, not the donors) then it makes sense for EA to fill those gaps. I think gap-filling and prioritisation are separate steps. With the additional criteria we’re still trying to assess value and therefore in a sense a certain kind of more broadly conceived assessment of cost-effectiveness. For example, if intervention A has a better cost per DALY than intervention B but equity considerations mean the HTA committee strongly prefers intervention B, then B is rightly considered a higher priority. We could then look at the practical issues of gaps, organisations that can deliver etc.
On specificity of recommendations, yes that’s fair. As you say this is just a blog so perhaps for future work. I also considered working out a clearer taxonomy of what is being prioritised (causes/programmes/interventions/charities etc). But this one was on the long side for a blog as it is
Thanks Jason, appreciate your thoughts.
Taking your points in order
Yes I essentially agree—though the other option available is to decide to work more through local institutions to prioritise and fund health services. Again yes this may be better done at scale. Though with the rate of growth in EA funding, I wouldn’t rule out a role for this kind of EA engagement. Or perhaps there is a role for EA as a kind of catalytic funder, investing in frameworks/platforms for more effective aid policy from states and major multilaterals.
I think you mean that if there are gaps for highly cost-effective services that aren’t being delivered by other donors (or indeed the national health system, we should remember that even in the very poorest countries, national institutions are still likely to be the main healthcare funder and provider, not the donors) then it makes sense for EA to fill those gaps. I think gap-filling and prioritisation are separate steps. With the additional criteria we’re still trying to assess value and therefore in a sense a certain kind of more broadly conceived assessment of cost-effectiveness. For example, if intervention A has a better cost per DALY than intervention B but equity considerations mean the HTA committee strongly prefers intervention B, then B is rightly considered a higher priority. We could then look at the practical issues of gaps, organisations that can deliver etc.
On specificity of recommendations, yes that’s fair. As you say this is just a blog so perhaps for future work. I also considered working out a clearer taxonomy of what is being prioritised (causes/programmes/interventions/charities etc). But this one was on the long side for a blog as it is