Date: May 13 – 24, 2024

Time: 7 – 10 AM EDT (3 hours)

Duration: 3 hours of training each day for eight days spread over a two-week period.

Delivery format: Virtual + Hybrid

As we navigate the complexities of global health challenges, including pandemics, conflicts, and economic uncertainties, the imperative for strong health systems is clearer than ever. The World Bank Group, a leading investor in health systems, is committed to equipping you with the knowledge and tools necessary to drive progress towards Universal Health Coverage (UHC) and other Health Reform Priorities.

This interactive course is designed to equip participants with the latest insights from the health sector, promoting a systems approach to effectively tackle health system challenges. Our goal is to stimulate meaningful policy dialogue and build technical capacity, setting the stage for strategic health reforms. The curriculum offers a range of perspectives and practical solutions, empowering participants to confidently navigate and resolve health-related issues.

The course is tailored for policymakers, senior and mid-level government officials, health professionals, and anyone with an interest in the complexities of health systems and their pivotal role in achieving UHC and priority health reforms.

Please note that this year's event will be by invitation only, allowing us to better manage participant engagement, course activities, and to maximize the impact of the program. We believe this approach will enhance the learning experience for all attendees. Session materials may be available upon request. We appreciate your understanding and look forward to a productive and insightful course.

World Bank Blogs - Published on Investing in Health - New malaria vaccines will save lives. How can we ensure a sustainable rollout?- By CHIJIOKE OKORO, NOEL CHISAKA, CAROLINA KERN - FEB 7, 2024

Last month, Cameroon became the first country to start rolling out malaria vaccination as part of its routine immunization program, with Burkina Faso joining just yesterday. This follows successful malaria vaccine trials in Ghana, Kenya, and Malawi where over 2 million children participated in evaluating RTS, S – one of two WHO-recommended vaccines to fight malaria.

According to the Malaria Vaccine Implementation Programme—a body created to assess the public health use of the RTS, S—the vaccine prevents around 75% of malaria episodes when given seasonally in conjunction with other effective malaria interventions.   Implementation data also points to a substantial fall in severe malaria hospitalizations and a remarkable (13%) drop in all-cause mortality (i.e., not just from malaria) from use of the vaccine.

New tool in the fight against malaria

This is big news: malaria is one of the world’s deadliest diseases, killing over half a million people a year, mainly children under five years of age in sub-Saharan Africa. Lower immunity during pregnancy makes it a particularly dangerous disease for women as well, with up 25 million pregnant women affected annually.

Malaria has a major impact on families due to the heavy burden it places on households. Treatment is expensive – and must often be sought multiple times a year. It also puts a strain on health systems, especially primary health care services since clinics and dispensaries are the main providers of treatment and prevention interventions.

The economic costs of malaria are estimated to be huge – though difficult to quantify precisely due to gaps in data. Malaria causes missed days at work or school, as well as drops in productivity. One estimate suggests that, among countries with intense transmission, malaria reduces GDP growth by up to 1.3%.

Against this backdrop, there are several opportunities to support the sustainable rollout of new malaria vaccines, as part of a package of essential interventions.

1. Relentless focus on health systems

Malaria control has been an important part of the World Bank’s health portfolio for over three decades. Its experience in supporting health systems – through analytics, technical support, and financing – remains critical to providing support for this new vaccine, as part of routine immunization programs.

It is not a simple question of procuring enough doses, though even this isn’t always straightforward. Running a successful immunization program requires health ministries to train healthcare workers and ensure adequate vaccine storage. Robust information systems are also necessary to record vaccine doses delivered and rationalize how they fit with other vaccines that form part of a country’s immunization schedule.

Demand generation at community level is a major consideration since RTS, S – also known as Mosquirix – is currently set to be delivered in four doses. While most doses can be given along with other vaccines that fall within current immunization programs, an additional visit will likely be needed to adhere to the recommended regimen. Families will need to be convinced that this extra trip to the clinic is worth it. Combating vaccine hesitancy for other reasons – be it safety or perceived ineffectiveness – is another consideration.

There are also questions of how to sequence and coordinate the roll out and how to deliver the vaccine alongside other health and environmental interventions. Complementary control measures such as providing insecticide-treated nets, clearing vegetation, and draining stagnant water must continue to be incorporated as part of malaria control efforts, which means strong collaboration between numerous departments and ministries. This level of multisectoral collaboration may prove challenging given the vertical way in which most vaccine programs are delivered and how difficult it can be to change long established ways of workings.

2. Support for long term planning and budgeting

The World Bank’s support for strengthening planning and resource prioritization is critical in helping countries implement cost-effective and equitable interventions, while considering financial and health systems constraints.

This support will be critical given that there is a now a second vaccine – R21/Matrix-M – on the market that is about half the price of RTS, S and is easier to produce, meaning that there are likely to be fewer supply constraints.

But even with a cheaper vaccine, there are still likely to be significant financing gaps. In the short term, there may be scope for the World Bank to leverage existing immunization-focused operations to support countries with malaria vaccine delivery (as is the plan in the case in Nigeria) or to look at how broader health systems strengthen programs could play a role.

For countries that aren’t receiving vaccine delivery support in the short term, but who would like to introduce malaria vaccines, new World Bank financing could be considered as part of broader system financing. In the longer term, fiscal space analyses will be important as countries navigate the process of moving towards full self-financing of vaccines.

3. Strong partnerships

The important gains that have already been made on malaria prevention, control, and treatment would not have been possible without strong and sustained partnerships, and this must continue. 

The World Bank is proud to be a founding partner of Gavi, The Vaccine Alliance, who aims to introduce RTS, S in 20 African countries in 2024 reaching over 6 million children. The World Bank works closely with Gavi as a board member and technical partner at country level. In addition, it is part of various global technical teams including the Malaria Vaccine Coordination Team, which is helping countries with their grant applications to Gavi and is also part of broader prioritization discussions.

It has also recently committed to stronger collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria, whose efforts to strengthen country malaria control/elimination interventions have been critical over the last two decades. Efforts to operationalize this pledge, especially at country level, are currently under way with work set to focus on climate and health, health financing and regional manufacturing – all highly relevant to malaria control.

These existing partnerships may provide an entry point to support Gavi and the Global Fund’s recent commitment to optimize the deployment of malaria vaccines ensuring that they are not delivered as a standalone intervention, but in conjunction with other proven, cost-effective measures.    

The World Bank recently launched the Climate and Health Program at COP28 to support low carbon, resilient health systems, and foster partnerships for climate-health investments

World Bank - Health - Brief - December 1, 2023

Impact of Climate on Health - Short Video

Climate change: a global health emergency

As the global climate crisis escalates, its devastating impacts on human health and well-being will also accelerate. No one anywhere around the globe is beyond its reach, though millions of people – notably, women, children, the elderly, ethnic minorities, people with pre-existing health conditions, and those living in poverty – are among the most vulnerable.

Changing climate conditions are increasing heat-related illnesses and deaths; changing the patterns of infectious disease transmission, making deadly disease outbreaks and pandemics more likely; worsening maternal and child health outcomes; and intensifying health impacts from extreme weather events such as floods, droughts, wildfires, and windstorms. Climate change exerts significant strains on health systems, simultaneously increasing demand for health services whilst also impairing the system’s ability to respond. The climate crisis is also rapidly deteriorating access to basic human needs such as food security, safe drinking water and sanitation, and clean air. The result, according to new World Bank data, is that a warmer climate could lead to at least 21 million additional deaths by 2050 from just five health risks: extreme heat, stunting, diarrhea, malaria, and dengue.

Unabated climate change is also expected to make the global goal of poverty reduction even more challenging to reach. A recent World Bank study estimates that climate change may push an additional 132 million people (more than half of whom live in Sub-Saharan Africa and South Asia), into extreme poverty by 2030, with 44 million of these driven by health impacts. (Read more)

See also related Blog - 

The climate crisis is driving a global public health emergency by

• VANESSA KERRY
• MAMTA MURTHI

JANUARY 02, 2024

World Bank Blogs - Published on Investing in Health - Fair processes in health financing policies for universal health coverage - By CHRISTOPH KUROWSKI; TRYGVE OTTERSEN; OLE F. NORHEIM; ELINA DALE - JULY 12, 2023

A new report provides recommendations for processes countries can use to develop fair and equitable health financing policies. Copyright: World Bank

In many developing countries health financing is not only inefficient and insufficient, it’s inequitable: People in developing countries pay over half a trillion dollars annually out-of-pocket for health services, which pushes about 100 million people into extreme poverty each year.

Policies regarding who contributes and how much, how resources are pooled to spread financial risk, what services are guaranteed to all, and how to purchase health services, can significantly reduce these inequities and bring countries closer to universal health coverage (UHC).

But the very process of improving such policies toward more equity and fairness can also lead to fairer outcomes and better governance overall.

Fair processes for equitable health financing

This is the topic we delve into in a new report written by the World Bank, the Norwegian Institute of Public Health, and the Bergen Centre on Ethics and Priority Setting. We also provide recommendations for the process countries can follow in developing fair and equitable health financing policies.

The Open and Inclusive: Fair Processes for Financing Universal Health Coverage report makes a case that procedural fairness plays a critical role for countries committed to UHC because it can contribute to more equitable outcomes, strengthen the legitimacy of decision processes, build trust in authorities, and promote the sustainability of health financing reforms.

To facilitate this, the report describes key health financing decisions —decisions, for example, with an impact on equity in service coverage and financial protection – where questions of procedural fairness need to be considered.

It then derives three guiding principles for the assessment of procedural fairness: equality (e.g., in access to information, opportunities to express views and to influence decisions), impartiality (e.g., ensuring that vested interests do not unduly influence the decision), and consistency over time (e.g., rules and procedures for decision making are stable over time and predictable).

Assessing procedural fairness in health financing decision-making

To facilitate the practical application of these principles, the report outlines criteria that can be used to determine if the procedures for making health financing decisions in any setting are fair.

These are organized into three domains (Figure 1). Information, the first domain, relates to open decision-making, covering reason-giving, transparency, and accuracy of information. The second domain, voice, includes participation and inclusiveness, creating opportunities for the public to express opinions and perspectives. Oversight, the third domain, includes revisability and enforcement of fairness criteria and the resulting decisions.

To illustrate how these criteria can be applied in practice, the report presents a range of country experiences in developing health financing policies, cutting across revenue generation, pooling, and purchasing.

Figure 1: Principles and operational criteria of procedural fairness

For instance, Ethiopia and Thailand use organizational arrangements that require public participation on different decision-making bodies, as well as capacity-strengthening instruments such as civil servant training for generating and using evidence.

Overall policy directions vs. technical decisions

The report recognizes that the criteria need not be applied with the scope and intensity to all types of health financing decisions. It distinguishes between decisions that set the overall directions of health financing policy (e.g., whether to introduce social health insurance on top of a tax-financed system) and more technical decisions (e.g., whether new medicines should be publicly funded, taking into account data on their safety, effectiveness and costs). Indeed, many countries ensure more extensive public participation—one of the fairness criteria—for decisions about policy directions, leaving narrow technical decisions to experts.

In cases where more limited public participation is justified, procedural fairness can be enhanced by strengthening other criteria such as reason-giving, transparency, and accuracy of information.

For example, if decisions regarding the public financing of new medicines rely on recommendations from technical experts, it is crucial that the reasons and underlying evidence supporting the acceptance or rejection of these medicines be made transparent and open to public scrutiny.

Towards a fairer process

Equity (fairness) in UHC outcomes is critical. This report suggests that procedural fairness involved in making these decisions is equally important. Even with limited resources, a growing number of countries are taking steps towards implementing a fairer process for decisions in health financing.  Governments, civil society, and international partners can work in complementary ways to apply these principles and criteria and improve procedural fairness, and through this, equity on the path to UHC.

You can download the full report here.

World Bank Blogs - Published on Investing in Health - By: JUAN PABLO URIBE - AUGUST 19, 2023

Digital-in-health: Unlocking the value for everyone

Digital-in-health goes beyond the conventional understanding of digital health by integrating technology and data across various aspects of health systems. Copyright: Erick Kaglan/World Bank

Digital solutions and data are powerful accelerators in the ongoing transformation of health systems and how health care is delivered for everyone. But current approaches are opportunistic, piecemeal, and fragmented.

New thinking—a digital-in-health approach—is needed to get more value out of technology and data, ensuring health systems deliver care that is accessible, equitable and cost-effective.

Digital-in-health goes beyond the conventional understanding of digital health by integrating technology and data across various aspects of health systems, including financing, service delivery, nutrition, research, pandemic preparedness, and medical education. Incorporating digital elements in every part of health systems and their management can make health services more accessible, efficient, affordable, and relevant to the population.

To support countries as they change their approach to digital-in-health, a new World Bank report, Digital-in-Health: Unlocking the Value for Everyone, offers pragmatic advice for governments and stakeholders embarking on this journey, irrespective of their digital proficiency or fiscal limitations.

Fighting long-standing and growing health challenges with digital tools

Health systems have made immense strides in the last years to achieve ‘health for all.’ Challenges remain, as COVID-19 taught us. But the pandemic opened windows of hope into how these challenges could be addressed in innovative and more integrated ways using digital technology and data.

 Countries that have been more successful in their COVID-19 responses have embedded technology and data in their health systems. Togo, for example, used digital tools to rapidly roll out an emergency cash transfers to vulnerable populations and vaccinate their citizens. In Indonesia, the Ministry of Health created a digital transformation office to improve health information and digital technology certification processes. These health system reforms are helping the countries move from using data for reporting to using digital technology to delivering services.

Beyond the pandemic, countries have made strides in integrating digital tools and using data to revamp their health systems. In Tajikistan, World Bank support for the healthy nation (Millati Solim) program will support health financing reform and digital technology alongside it. Peru has used connected data systems to streamline and better integrate the health services that they provide.

Unlocking the value of digital for everyone: Prioritize, Connect and Scale

Governments play an essential role: they must foster trust in and build capacity for digital technology use in health systems, promote fairness, and bridge the digital chasm rather than broaden it. To do this well, countries will need to focus on the following three key areas:

1. Prioritize: Governments need to choose digital solutions responding to people’s health needs and evidence based, and that are equitable
2. Connect to deliver new, more, better, and seamless health services: through leadership and partnership, data governance and regulations, by filling digital infrastructure gaps and health information gaps
3. Scale to ensure equitable access to all: improve digital skills and literacy, create synergy with wider digital transformation, nimble public-private and private-private partnerships, and support with financing, monitoring, and implementation.

Countries are at the forefront of this transformation, steering towards a digitally empowered and data-infused future for health. Navigating these waters of innovation will not be without hurdles. But with the right strategy - one that involves strong country leadership, good health data governance, private sector collaboration, evidence-based decision-making, a focus on interoperability and wider digital transformation across government systems and in society, and a keen eye on sustainability – the promised value of digital technologies can be realized for everyone.

Supporting countries to transform health systems

The World Bank, as always, stands as a steadfast ally, ready to support countries in leveraging digital tools to support universal health coverage. Over the past decade, the World Bank has invested almost $4 billion in digital health including in health information systems, digital governance, identification systems and infrastructure.

The World Bank will continue to support countries in their digital-in-health transformation, recognizing that every dollar for health systems strengthening, can be an investment in digital and data making health systems work better for everyone.

To download the report, click here. To learn more about the Digital-in-Health report, please visit this website.