The topic of the conference was global health, more specifically on the interaction between what was termed as ‘Global Health Diplomacy (GHD)‘ and the drive for Universal Health Care (UHC). The main organisers of the conference were NICE International ( whom Itad are currently working with – read more here). A key entry point to this discussion was the work that NICE International – and their partners around the world – are doing to promote the systematic generation of evidence based assessments. The assessments look at the costs of delivering health interventions and the subsequent use of this information by decision makers to make allocative decisions across health systems. There is a compelling case for promoting the use of such approaches in developing countries as a way of ensuring greater value for money of in country health expenditure and thus contributing to greater access to health interventions in amongst the populations.
The challenge, of course, is to explore how best this approach can be promoted and countries supported to implement it – and this is where, at least in part, the idea of ‘global health diplomacy’ comes in. One thing was clear from the discussions…GHD is a fuzzy concept and one which means many things to many people. However we were lucky enough to have ‘real life diplomats’ in our group (a UK ambassador, a delegate from the Japanese Ministry of Foreign Affairs and the Assistant Secretary for Global Affairs from the US Dept of Health and human Services for example). So our discussions were very much based on experience and in depth knowledge. We also had some leading experts from the BRICS countries in the meeting, who in many respects will have a key role to play in spearheading the idea of GHD as a means to promote better evidenced based health interventions both in their countries as well is in Least Developed Countries (LDCs).
It was a really exciting to be part of these discussions – as well as somewhat daunting: I was there on behalf of Itad because of our expertise on evaluation and measurement and health evaluations (see link) and so questions such as the following were sent my way during the conference discussions;
- how can we actually go about evaluating interventions that are being implemented – by nice international as well as other stakeholders in the room – in this arena?
- How can success be measured along the way to UHA?
- How can we show that the approaches advocated by the people attending the conference actually do make a difference and, for example, be shown to represent value for money to donors such as DfID, Rockefeller and the USG?
These are, of course, incredibly challenging questions (hence the ‘daunting bit!). However, on the last day of the conference we had a useful discussion about how approaches such as ‘Theory of Change’ analysis might lend themselves to providing an overarching evaluative framework for looking at this work both globally and in country. Such approaches are especially useful in debates such as these because they also help to tease out the conceptual logic of what is being discussed and. For example they force people to be clear about how they might see the relationship between say a joint delegation between Chinese and NICE International experts, to a country like Ghana and actual changes in Ghana health system in the future. Clarity on the Theories of Change – even for diplomatic exercises such as these – will certainly help us construct a way to better evaluate these types of approaches.
The main take away that was clear to me as I was driven away through the hills of northern Italy was the following: the attendees at this conference are currently some of the key people that are laying the foundations for making the aim of UHC a reality and indeed I am certain this group, along with many others, will play an increasingly important role in the future. Being part of the discussions of how this role can be clarified and how, indeed, the contribution can be measured, was without doubt a great privilege…So yes overall a great gig (and the views were not bad either!!)
