Health Systems and Reform Journal

Looking ahead, Wilson and Görgens emphasize the need to integrate data on service quality, geography, and patient needs to ensure that health financing is not only efficient but also equitable and responsive.

Read more: bit.ly/3X98qrO

These models also help make budget decisions more transparent and evidence-based, giving policymakers a powerful tool to defend data-driven choices in politically sensitive environments👇

For instance, modeling studies across 23 countries found that optimized allocations could reduce new HIV infections by 18% and HIV-related deaths by 29% by 2030👇

The COVID-19 pandemic made efficiency a necessity. As budgets shrink, health systems must find new ways to do more with less.

Mathematical optimization models help governments simulate different budget scenarios and identify how to distribute resources most effectively across health programs👇

How can governments make smarter decisions about where to invest limited health budgets?

David Wilson and Marelize Görgens from the World Bank explore how mathematical modeling can help countries get more health for every dollar spent🧵

Both phases of HBP in Colombia had their own pros and cons. They reflected the tension between seeing health as a fundamental human right, regardless of cost, and prioritizing HBP based on available funding. Read more: bit.ly/45aFyT8

But financial mismatches have persisted until today. Health care expenditure has been unable to cover all patient scenarios, leading to implicit rationing of health services👇

Later, in 2017, the priority-setting process shifted to exclusions. This promoted medical autonomy, reduced patient costs and efforts for legal action, and improved clinical and financial risk management for insurers👇

However, the institutional arrangements for priority-setting became clearer and more stable, and the processes and methodologies more robust👇

Also, the health system's financial sustainability faced threats from increased "acción de tutela" cases, which judicialize the right to health. Nevertheless, priority-setting frameworks improved, with clearer institutional arrangements and more robust processes👇

The explicit priority-setting process focused on inclusions was implemented between 1993 and 2017. During this time, various institutions were created and eliminated to determine the services and technologies included in the HBP👇

Since the major health system reform of 1993, Colombia’s HBP has had two main phases: one with an explicit priority-setting process focused on included health services and technologies, and one with explicit priority-setting process focused on the excluded ones👇

Health Benefits Packages (HBP) have been a key policy instrument for improving #UHC. Discover the research by Marcela Brun, Johnattan Garcia Ruiz, Javier Guzman on Colombia’s evolution in this field! 🧵

Ghana's sophisticated health financing infrastructure means the country could rapidly convert higher NCD prioritization into resource allocation if political commitment strengthens. Read more: bit.ly/4oBZFST

The study identifies the critical missing piece: public awareness. In democratic contexts like Ghana, citizen demand drives political action. Without broader recognition of NCD risks and costs, sustainable political commitment remains elusive 👇

These entrepreneurs achieved a major win: the recent passage of sugar-sweetened beverage taxes. How ? By generating evidence across all three policy streams—including research showing the tax would be acceptable to the public, which reassured politicians👇

But here's the encouraging part: Ghana has a vibrant ecosystem of policy entrepreneurs (individual specialists, civil society coalitions, and international partners) all actively developing and promoting solutions for NCDs 👇

The barriers are significant:

➡️Ghana allocates only 7% of its budget to health (vs. the 15% Abuja Declaration target)
➡️The National Health Insurance Scheme provides limited NCD coverage
➡️Donors prioritize other conditions
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The research applies Kingdon's Multiple Streams Framework to understand NCD financing. The authors found that Ghana has policies, guidelines, and governance structures, but diabetes isn't yet seen as a major societal threat👇

Why do diabetes and NCDs remain chronically underfunded in many countries, even when effective solutions exist?

This study focused on Ghana by Leonard Baatiema, Kristen Danforth, David A. Watkins, Joana Ansong, Adwoa Twumwaah Twum-Barimah, and Bruno Meessen reveals the barriers blocking progress🧵

3️⃣ Reform tax and subsidy policies: reduce support for sugar-rich foods while making healthy options more accessible.

Read more: bit.ly/476gOgq

2️⃣ Improve public communication: promote evidence-based information about diet and lifestyle, countering misinformation and the influence of fad diets, and helping people make informed, lasting health choices.
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The authors identify three key priorities where governments can make a real difference:

1️⃣ Detect risks earlier: shift from late-stage glucose testing to detecting insulin resistance much earlier.
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Applied to type 2 diabetes, this framework highlights the need for collective, system-level solutions rather than individual medical treatments. It reframes diabetes prevention as a shared public responsibility that requires coordinated policy action.
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The Common Goods for Health approach helps identify public actions that correct both market and government failures, areas where neither the private sector nor public policy alone can protect population health effectively.
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What can countries do to address the global rise of type 2 diabetes when existing market and government responses have fallen short?

In their new commentary, Agnes L. Soucat, Sylvestre Gaudin, and Abdo S. Yazbeck explore this question through the lens of the WHO’s Common Goods for Health framework🧵

The review highlights that while all countries face challenges in HTA institutionalization, HICs and UMICs have leveraged political support and international collaboration to overcome barriers. This points to potential strategies for LMICs and LICs.

Read more: bit.ly/3yYzq4P

4️⃣ Stakeholder‐related factors
5️⃣ Collaborative support for HTA

The review analyzed 77 empirical papers, mainly from HICs and UMICs. They identified five key sets of factors influencing HTA institutionalization:

1️⃣ Organizational resources for HTA
2️⃣ Legal Frameworks, Policies, and Guidelines for HTA
3️⃣ Learning and advocacy for HTA👇

What are the main factors that influence the institutionalization of HTA at the macro-level across all countries globally?

In this scoping review Rahab Mbau, Anna Vassall, Lucy Gilson, and Edwine Barasa found some interesting answers🧵