In this NYTimes op-ed, Pharos President Robert Hecht and Managing Director Shan Soe-Lin argue that after immunizing health workers and the elderly in the first phase of vaccination, US states should target hotspot communities in the immediate next phase to slow transmission of the virus and reopen the economy as soon as possible. Such geographic [..]
In an op-ed in Politico, Robert Hecht and Shan Soe-Lin argue that due to their enormous “epidemiological footprint”, universities should open in the fall of 2020 in a coordinated and regulated manner with thoughtful oversight from the states and cities where they are located. While empathizing with students, parents, and university administrators and appreciate the tremendous value [..]
We need to aggressively search for asymptomatic carriers, particularly among people who have frequent contact with the public and among vulnerable populations, Robert Hecht and Shan Soe-Lin argue in this New York Times op-ed. This includes those who are infectious but will never develop symptoms and those who will develop them days after the test. [..]
In an op-ed published in the Boston Globe on March 19th, Pharos Managing Director Shan Soe-Lin and President Robert Hecht explain why the prevailing guidance, in the midst of the current COVID-19 crisis, against wearing masks is wrong. They urge everyone to cover their face outside the home, in addition to washing hands frequently and practicing social distancing.
Shan and Rob argue that the “don’t touch your face” instruction is impossible for most people to follow as the urge to touch is hard-wired in utero. Studies show that humans touch their noses, eyes and mouths on average every 2.5 minutes. COVID-19 and other respiratory viruses cause infection through the mucous membranes on the face. By denying access to the nose, eyes and mouth, coronavirus and other respiratory infections can be prevented. Washable, reusable face masks are a simple way for people to protect themselves from their most direct threat: their own hands.
The op-ed notes that medical masks, including surgical and N95 masks, which are in desperately short supply, should be strictly reserved for health professionals at greatest risk for infection.
Widespread adoption of non-medical masks requires major behavior change and the elimination of stigma against wearing masks, but these challenges can and must be overcome. Masks are an important and badly under-utilized public health tool to protect the public against COVID-19.
Photo Credit: The Boston Globe
In a blog that appeared on January 23, 2020, CGD Director Kalipso Chalkidou and Pharos President Robert Hecht explain the importance of country governments adopting Health Technology Assessment (HTA) and Pooled Purchasing of health commodities, especially in countries undergoing reductions in donor aid for health and simultaneous pressures to increase domestic funding. The authors argue, with multiple examples, that low and middle income countries that build HTA are better able to assess the costs and benefits of investing in different health services and technologies with their own funds and to make wise spending decisions. Similarly, by pooling their purchases of drugs, vaccines, diagnostics, and other health commodities at the national level and with other countries in “buyers clubs”, they can obtain more favorable prices and stretch their scarce health ministry and insurance budgets further to fight major diseases and treat more of their citizens. While some low and middle income countries are starting to use HTA and Pooled Purchasing, many still lack these mechanisms and need to move swiftly to incorporate them in their health budgeting and spending systems.
In a blog that appeared on November 28, 2019, on the Center for Global Development website, Pharos President Robert Hecht and Program Associate Devyn Rigsby, along with two colleagues from CGD, examine the challenges to family planning programs in middle-income countries facing simultaneous shifts away from donor health aid in multiple areas including HIV, TB, malaria, and family planning. The authors argue that, unless managed well, looming changes in the donor funding landscape could undermine hard-won gains and threaten progress on family planning—a key contributor to advancing health, gender equality, and women’s economic opportunities. The blog, based on a longer technical research paper from Pharos, concludes that the family planning community must place transition much higher on its agenda and act quickly to prepare for it, sponsoring transition risk assessments and plans in the countries where dramatic changes are expected to occur soon. The blog summarizes key findings and practical recommendations to promote successful transition and sustained progress in family planning.
In April 2019, this article on HCV screening in Malaysia was published in the journal, Value of Health Regional Issues. Authored by Pharos’s Lindsey Hiebert and colleagues at the University of Malaya and the Netherlands Institute for Public Health and the Environment, it models an efficient strategy for screening patients in order to reach Malaysia’s HCV elimination targets. [..]
In an article published on January 28, 2019 in the Journal of Global Health Reports, a team from Pharos including President Robert Hecht and Project Manager Lindsey Hiebert, along with partners from the Paris-based Coalition Plus and the Moroccan Association de Lutte Contre le SIDA, present the health and economic benefits arguments in favor of a large-scale investment in eliminating hepatitis C in the Morocco over the coming decade.
The article entitled “Morocco investment case for hepatitis C: using analysis to drive the translation of political commitment to action” suggests that a phased investment of $650 million over the next 12 years could save more than 50,000 lives and prevent 140,000 new infections, especially among the poorest who are currently not eligible for treatment through publicly-mandated health insurance. As the cost of hepatitis drugs and tests continues to fall worldwide, the overall price tag for hepatitis C elimination could even be lower.
Since the Morocco investment case was discussed with the Minister of Health in 2017 and presented formally to the Government last year, Moroccan health leaders have announced their commitment to purchasing Hepatitis C drugs for a first cohort of 6,500 patients on the road to a large-scale national program.
In a commentary published on the Health Affairs Blog on December 14, and based on a more detailed technical report (available at http://centerforpolicyimpact.org/donor-transitions-hiv/), Pharos staff and colleagues from Duke University point to the serious risks of declining donor aid in many middle-income countries for the sustained success of HIV programs, especially for stigmatized key populations including men who have sex with men, sex workers, transgender people, and those who inject drugs.
Over $500 billion has been spent on HIV programs in low- and middle-income countries over the past two decades, and major gains have been achieved in lowering new infections, illnesses and deaths, and mitigating other negative impacts of AIDS on society. However, when donor funding ends and countries transition to domestically-funded responses, they often struggle to maintain these programs, particularly for key populations.
Drawing on a series of country examples, we highlight lessons learned and make recommendations that can help countries to mitigate future transition risks and improve the impact of their HIV investments, thereby protecting the health of their populations and safeguarding the gains they have achieved to date in their fight against AIDS.
How India Can Improve its Take Home Rations Program to Boost Child and Maternal Nutrition, October 2018
In a blog article published in Brookings Future Development earlier this week, and based on four policy briefs developed by Pharos (available at https://pharosglobalhealth.com/resources/), three Pharos staff and Dr. Rajan Sankar (Program Director- Nutrition at Tata Trusts) describe the current state of malnutrition in India and the challenges facing the government’s premier nutrition initiative under the Integrated Child Development Service (ICDS) — the Take-Home Rations (THR) program.
This multi-billion dollar government-financed program has tremendous potential to improve malnutrition across India, yet changes are urgently needed to make the most of it, including steps to improve THR formulation and composition; strengthen the diverse production and distribution systems that currently operate across India’s states; and enhance monitoring and accountability.
If adopted, the recommendations we make in our briefs would provide a more solid foundation for India to achieve its ambitious nutrition Vision 2022 targets and alleviate malnutrition for millions of children and women.
In a blog article published on Brookings Future Development and written by Dr. Gavin Yamey and Ipchita Bharali of the Duke University Center for Policy Impact in Global Health, along with three Pharos staff members, we compare countries where foreign aid has wound down with those that are likely to soon stop getting aid. The focus is on health, but the findings may apply to other sectors as well. We find that the upcoming country cohort—which includes Nigeria and Pakistan—appears to be weaker in many dimensions of macroeconomic performance, fiscal capacity, health systems and financing, governance, and equality. These differences may have important implications for country transition (“graduation”) from donor aid, in terms of timing, processes, transitional support, and related donor policies and should be considered by policymakers and the global community.
In an article published in Health Policy and Planning, three Pharos staff and other collaborators from South Africa, Harvard, and Imperial College, and the Center for Disease Analysis present one of the first comprehensive investment cases for hepatitis scale-up in low and middle- income countries. In South Africa, Pharos supported the development of a five-year national strategy for hepatitis B and C, covering activities including hepatitis B birth dose vaccination, prevention of vertical transmission, treatment of hepatitis B, and treatment of hepatitis C with the new generation of highly-effective cures. The investment case synthesizes the expected cost, health impact, cost-effectiveness, and budget impact of this package of interventions. The paper finds that scale up of hepatitis investments could be both affordable and represent good value for money for South Africa, while averting thousands of new infections, deaths, and cases of advanced liver disease
In this Viewpoint in the Journal of Global Health, Prof Stephen Resch of the Harvard TH Chan School of Public Health and Prof Robert Hecht of Pharos Global Health Advisors and the Yale School of Public Health provide their thoughts and suggestions on ways to improve the data, analysis, and policy advice surrounding financial transitions in global health.
Resch and Hecht stress that, worryingly, the processes and tools we have today for managing transitions are seriously incomplete and fragmented, and only weakly coordinated across donor agencies and within countries.
They highlight the main underlying trends driving transitions away from donor support for health; point to the largest risks and challenges connected with these transitions; underscore which analytical tools and policy processes need to be further strengthened at global and country levels in order to achieve more successful donor transitions in health. The Viewpoint concludes with a series of recommendations that the authors argue should be adopted by researchers, donor agency officials, and country leaders responsible for managing financial transitions.
The global nutrition community has recommitted to the 1000 day agenda with energy and enthusiasm in recent years, but too targeted a focus could risk missing other critical development windows that ensure a healthy child becomes a healthy adult. A particular challenge is the emerging adolescent girl agenda, where little progress has been made to meet the unique health and nutrition needs of this vulnerable age-group. This blog post highlights the burden of nutritional deficiencies of adolescent girls and the need for the global community at every level to do more to address these needs. Prioritizing the health of adolescent girls would ensure the cognitive, economic, and developmental potential of both current and future generations is fully realized.
Helping countries transition from donor aid for health: recent experience at the Global Fund, July 2017
As dozens of middle-income countries transition away from donor health aid, development institutions need to do more to assist them and better protect hard-won health gains. In this PLoS blog, Robert Hecht and Rachel Wilkinson highlight recent efforts by the Global Fund to improve country transitions, using targeted technical assistance to assess risks, design country plans, and stimulate domestic financing. This kind of technical support is key to future health aid to middle-income countries – more donors should follow the Global Fund’s lead in this area.
Health Affairs: Why President Trump Should Use Foreign Aid for Health to Make America Great, April 2017
In this Health Affairs commentary, Professor Sten Vermund, Dean of the Yale School of Public Health, and Pharos President Robert Hecht argue that maintaining and even increasing U.S. foreign assistance for global health is consistent with President Donald Trump’s “America First” policies, as well as contributing to saving millions of lives around the world. There is an urgent need to protect U.S. spending for global health, at a time when the Trump Administration is threatening to cut foreign aid dramatically.
Shan Soe-Lin and Robert Hecht, along with Austin Jaspers, have produced a report for the CSIS Global Health Policy Center, highlighting the benefits of investing in stunting, reviewing past US nutrition investments, assessing current the US government nutrition strategy, analyzing the barriers to US commitments being fully realized, and proposing possible options for the next Administration.
This Health Affairs blog on country transitions in global health, co-authored by Pharos President Robert Hecht and Professor Sara Bennett of Johns Hopkins Bloomberg School of Public Health, highlights the importance of the transition of middle-income countries away from donor assistance in the health sector and major challenges these transitioning countries face, and recommends an analytical agenda to support stronger and more sustained transitions.
In this commentary, Pharos President Robert Hecht and CSIS Global Health Policy Center Director Stephen Morrison explore a new and emerging paradigm for development assistance for health, in which middle income countries use domestic funding to pay for drugs, vaccines, health workers, and other inputs to disease control scale up, while donors focus their limited resources on key global public goods – knowledge and technical assistance that can help to shape and accelerate the design and implementation of life-saving interventions such as Hepatitis C treatment.
#AIDS2016: As donor funding falls, South Africa must increase its HIV funding and use it more efficiently, July 2016
In this article written for the South African Mail and Guardian newspaper in the run-up to the International AIDS Conference in Durban, Pharos President Robert Hecht points to South Africa’s tremendous achievements of the past decade in fighting AIDS, highlights future financing gaps and challenges facing the Government, and suggests ways in which South Africa can mobilize more funds and use them more efficiently to combat the severe epidemic.