Innovative Financing Mechanisms for Global Health: Overview & Considerations for U.S. Government Participation

Defines, classifies, and inventories innovative financing mechanisms for global health such as front-loading funds, public-private research partnerships, and performance incentives. Examines U.S. government involvement and policy considerations

Donor Government Funding for HIV in Low- and Middle-Income Countries in 2020

This report, Donor Government Funding for HIV in Low- and Middle-Income Countries in 2020, tracks funding levels of the donor governments that collectively provide the bulk of international assistance for AIDS through bilateral programs and contributions to multilateral organizations. The new report, produced as a partnership between KFF and UNAIDS, provides the latest data available on donor funding disbursements based on data provided by governments. It includes their bilateral assistance to low- and middle-income countries and contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria as well as UNITAID

Donor Government Funding for HIV in Low- and Middle-Income Countries in 2022

This report, Donor Government Funding for HIV in Low- and Middle-Income Countries in 2022, tracks funding levels of the donor governments that collectively provide the bulk of international assistance for AIDS through bilateral programs and contributions to multilateral organizations. The new report, produced as a partnership between KFF and UNAIDS, provides the latest data available on donor funding disbursements based on data provided by governments. It includes their bilateral assistance to low- and middle-income countries and contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria as well as UNITAID

Mapping the Donor Landscape in Global Health: Tuberculosis

Which donors are working in which countries and on what issues? How can country recipients of aid best identify those donors? Are donor governments themselves adequately aware of one another's presence and efforts on identical issues? These questions reflect key challenges facing donors of international assistance, country recipients of assistance, civil society, and other stakeholders working in the development field, and highlight issues that can make it difficult to effectively negotiate, coordinate, and deliver programs. In the health sector such issues are particularly relevant given the proliferation in the number of donors providing health aid to low- and middle-income countries, and the amount of that aid during the last decade. Such issues carry a new significance in the current era of economic austerity, one that has led donors and recipients to seek more streamlined approaches to health assistance that achieve "value for money." To provide some perspective on the geographic presence of global health donors and to help stakeholders begin to answer some of the above questions, the Kaiser Family Foundation is undertaking a series of analyses to describe the global health "donor landscape." Using three years of data from the Organisation for Economic Co-operation and Development (OECD), we map the geographic landscape of global health donor assistance, looking both at donor presence and magnitude of donor assistance by issue area, region, and country. The effort is intended to shed new light on donor presence within and across recipient countries, and to produce a set of figures and tools that stakeholders can use in both donor and recipient countries. From at least the early 2000s, there have been organized efforts to push for greater transparency and better coordination between donors, and between donors and recipients. These calls contributed to a series of international declarations on aid effectiveness such as the 2002 Monterrey Consensus on Financing for Development and the 2005 Paris Declaration on Aid Effectiveness, in which donors and recipient nations agreed to adhere to a code of good practice and a set of principles that would guide and improve donor assistance. In part, the principles were designed to help alleviate some of the administrative burdens on countries from having multiple donors, and to increase the impact derived from donor funding. They have also, more recently, focused on the importance of donor transparency for increasing "country ownership" by recipients of aid; that is, a country-led response to designing and implementing development programs. In global health, uncoordinated donor activities can reduce efficiency and result in missed opportunities to leverage partnerships, streamline processes, and share experiences. While there have been several health-focused efforts aiming to improve donor coordination and donor transparency these challenges continue today and have gained new significance given the current economic environment.Indeed, with signs that donor assistance is flattening, there has been an even higher premium placed on improving coordination and leveraging existing funding and programs. This report focuses on international assistance for tuberculosis

Mapping The Donor Landscape in Global Health: HIV/AIDS

This report maps the complex network of international assistance aimed at addressing the global impact of HIV/AIDS. The analysis identifies 37 different donors, comprising 26 nations providing bi-lateral support and 11 multilateral programs, providing assistance to 143 recipient countries over a three-year period through 2011. Key findings include:The U.S. provides almost two-thirds of all HIV/AIDS international assistance. The next largest donor, the Global Fund, provides one fifth of all assistance. Together they account for an average of 80 percent global HIV/AIDS assistance.On average, 10 donors were present in each recipient country. Fourteen recipient countries had more than 20 donors present during the three-year period: Ethiopia, Kenya, Tanzania, Malawi, Zimbabwe, Mozambique, Rwanda, South Africa, Uganda, Vietnam, Zambia, India, Burkina Faso and Mali.The biggest donor varies by region, with the United States providing the largest share of assistance in sub-Saharan Africa and North & Central America; the Global Fund providing the largest share in Europe, the Middle East, North Africa, South and Central Asia, South America and Far East Asia; and Australia providing the largest share in Oceania

Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender Individuals in the U.S.

Lesbian, gay, bisexual, and transgender (LGBT) individuals often face challenges and barriers to accessing needed health services and, as a result, can experience worse health outcomes. These challenges can include stigma, discrimination, violence, and rejection by families and communities, as well as other barriers, such as inequality in the workplace and health insurance sectors, the provision of substandard care, and outright denial of care because of an individual's sexual orientation or gender identity. While sexual and gender minorities have many of the same health concerns as the general population, they experience certain health challenges at higher rates, and also face several unique health challenges. In particular, research suggests that some subgroups of the LGBT community have more chronic conditions as well as higher prevalence and earlier onset of disabilities than heterosexuals. Other major health concerns include HIV/AIDS, mental illness, substance use, and sexual and physical violence. In addition to the higher rates of illness and health challenges, some LGBT individuals are more likely to experience challenges obtaining care. Barriers include gaps in coverage, cost-related hurdles, and poor treatment from health care providers. Several recent changes within the legal and policy landscape serve to increase access to care and insurance for LGBT individuals and their families. Most notably the implementation of the Affordable Care Act (ACA) and the Supreme Court's overturning of a major portion of the Defense of Marriage Act (DOMA), as well as recent steps taken by the Obama Administration to promote equal treatment of LGBT people and same-sex couples in the nation's health care system have reshaped policy affecting LGBT individuals and their families. The ACA expands access to health insurance coverage for millions, including LGBT individuals, and includes specific protections related to sexual orientation and gender identity. The Supreme Court ruling on DOMA resulted in federal recognition of same-sex marriages for the first time, which also serves to provide new health insurance coverage options. In addition, President Obama's administration has undertaken a variety of other initiatives to improve the health and well-being of LGBT individuals, families, and communities. This issue brief provides an overview of what is known about LGBT health status, coverage, and access in the United States, and reviews the implications of the ACA, the overturning of DOMA, and other recent policy developments for LGBT individuals and their families going forward

Mapping the Donor Landscape in Global Health: Malaria

Which donors are working in which countries and on what issues? How can country recipients of aid best identify those donors? Are donor governments themselves adequately aware of one another's presence and efforts on identical issues? These questions reflect key challenges facing donors of international assistance, country recipients of assistance, civil society, and other stakeholders working in the development field, and highlight issues can make it difficult to effectively negotiate, coordinate, and deliver programs. In the health sector such issues are particularly relevant given the proliferation in the number of donors providing health aid to low and middle income countries, and the amount of that aid during the last decade. Such issues carry a new significance in the current era of economic austerity, one that has led donors and recipients to seek more streamlined approaches to health assistance that achieve "value for money." To provide some perspective on the geographic presence of global health donors and to help stakeholders begin to answer some of the above questions, the Kaiser Family Foundation is undertaking a series of analyses to describe the global health "donor landscape." Using three years of data from the Organisation for Economic Co-operation and Development (OECD), we map the geographic landscape of global health donor assistance, looking both at donor presence and magnitude of donor assistance by issue area, region and country. The effort is intended to shed new light on donor presence within and across recipient countries, and to produce a set of figures and tools that stakeholders can use in both donor and recipient countries. From at least the early 2000s, there have been organized efforts to push for greater transparency and better coordination between donors, and between donors and recipients. These calls contributed to a series of international declarations on aid effectiveness such as the 2002 Monterrey Consensus on Financing for Development and the 2005 Paris Declaration on Aid Effectiveness, in which donors and recipient nations agreed to adhere to a code of good practice and a set of principles that would guide and improve donor assistance. In part, the principles were designed to help alleviate some of the administrative burdens on countries from having multiple donors, and to increase the impact derived from donor fundingThey have also, more recently, focused on the importance of donor transparency for increasing "country ownership" by recipients of aid; that is, a country-led response to designing and implementing development programs. In global health, uncoordinated donor activities can reduce efficiency and result in missed opportunities to leverage partnerships, streamline processes, and share experiences. While there have been several health-focused efforts aiming to improve donor coordination and donor transparency these challenges continue today and have gained new significance given the current economic environment. Indeed, with signs that donor assistance is flattening, there has been an even higher premium placed on improving coordination and leveraging existing funding and programs. This report focuses on international assistance for malaria

Gemcitabine and cisplatin neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma: Predicting response and assessing outcomes

PURPOSE: To evaluate gemcitabine-cisplatin (GC) neoadjuvant cisplatin-based chemotherapy (NAC) for pathologic response (pR) and cancer-specific outcomes following radical cystectomy (RC) for muscle-invasive bladder cancer and identify clinical parameters associated with pR.; MATERIALS AND METHODS: We studied 150 consecutive cases of muscle-invasive bladder cancer that received GC NAC followed by open RC (2000-2013). A cohort of 121 patients treated by RC alone was used for comparison. Pathologic response and cancer-specific survival (CSS) were compared. We created the Johns Hopkins Hospital Dose Index to characterize chemotherapeutic dosing regimens and accurately assess sufficient neoadjuvant dosing regarding patient tolerance.; RESULTS: No significant difference was noted in 5-year CSS between GC NAC (58%) and non-NAC cohorts (61%). The median follow-up was 19.6 months (GC NAC) and 106.5 months (non-NAC). Patients with residual non-muscle-invasive disease after GC NAC exhibit similar 5-year CSS relative to patients with no residual carcinoma (P = 0.99). NAC pR (≤ pT1) demonstrated improved 5-year CSS rates (90.6% vs. 27.1%, P < 0.01) and decreased nodal positivity rates (0% vs. 41.3%, P<0.01) when compared with nonresponders (≥ pT2). Clinicopathologic outcomes were inferior in NAC pathologic nonresponders when compared with the entire RC-only-treated cohort. A lower pathologic nonresponder rate was seen in patients tolerating sufficient dosing of NAC as stratified by the Johns Hopkins Hospital Dose Index (P = 0.049), congruent with the National Comprehensive Cancer Network guidelines. A multivariate classification tree model demonstrated 60 years of age or younger and clinical stage cT2 as significant of NAC response (P< 0.05).; CONCLUSIONS: Pathologic nonresponders fare worse than patients proceeding directly to RC alone do. Multiple predictive models incorporating clinical, histopathologic, and molecular features are currently being developed to identify patients who are most likely to benefit from GC NAC. Copyright © 2015 Elsevier Inc. All rights reserved