Universal health coverage and intersectoral action for health: Key messages from Disease Control Priorities, 3rd edition

Dean T. Jamison, Ala Alwan, Charles N. Mock, Rachel Nugent, David Watkins, Olusoji Adeyi, Shuchi Anand, Rifat Atun, Stefano Bertozzi, Zulfiqar Bhutta, Agnes Binagwaho, Robert Black, Mark Blecher, Barry R. Bloom, Elizabeth Brouwer, Donald A.P. Bundy, Dan Chisholm, Alarcos Cieza, Mark Cullen, Kristen DanforthNilanthi de Silva, Haile T. Debas, Peter Donkor, Tarun Dua, Kenneth A. Fleming, Mark Gallivan, Patricia J. Garcia, Atul Gawande, Thomas Gaziano, Hellen Gelband, Roger Glass, Amanda Glassman, Glenda Gray, Demissie Habte, King K. Holmes, Susan Horton, Guy Hutton, Prabhat Jha, Felicia Knaul, Olive Kobusingye, Eric L. Krakauer, Margaret E. Kruk, Peter Lachmann, Ramanan Laxminarayan, Carol Levin, Lai Meng Looi, Nita Madhav, Adel Mahmoud, Jean Claude Mbanya, Anthony Measham, María Elena Medina-Mora, Carol Medlin, Anne Mills, Jody Anne Mills, Jaime Montoya, Ole Norheim, Zachary Olson, Folashade Omokhodion, Ben Oppenheim, Toby Ord, Vikram Patel, George C. Patton, John Peabody, Dorairaj Prabhakaran, Jinyuan Qi, Teri Reynolds, Sevket Ruacan, Rengaswamy Sankaranarayanan, Jaime Sepúlveda, Richard Skolnik, Kirk R. Smith, Marleen Temmerman, Stephen Tollman, Stéphane Verguet, Damian G. Walker, Neff Walker, Yangfeng Wu, Kun Zhao

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.

Original languageEnglish (US)
JournalThe Lancet
DOIs
StateAccepted/In press - Jan 1 2017

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Universal Coverage
Health
Costs and Cost Analysis
Mortality
Fossil Fuels
Community Health Centers
Premature Mortality
Stillbirth
Quality-Adjusted Life Years
United Nations
Conservation of Natural Resources
Poverty
Health Policy
Child Development
Contraception
Palliative Care
Health Status
Cost-Benefit Analysis
Referral and Consultation
Smoking

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Universal health coverage and intersectoral action for health : Key messages from Disease Control Priorities, 3rd edition. / Jamison, Dean T.; Alwan, Ala; Mock, Charles N.; Nugent, Rachel; Watkins, David; Adeyi, Olusoji; Anand, Shuchi; Atun, Rifat; Bertozzi, Stefano; Bhutta, Zulfiqar; Binagwaho, Agnes; Black, Robert; Blecher, Mark; Bloom, Barry R.; Brouwer, Elizabeth; Bundy, Donald A.P.; Chisholm, Dan; Cieza, Alarcos; Cullen, Mark; Danforth, Kristen; de Silva, Nilanthi; Debas, Haile T.; Donkor, Peter; Dua, Tarun; Fleming, Kenneth A.; Gallivan, Mark; Garcia, Patricia J.; Gawande, Atul; Gaziano, Thomas; Gelband, Hellen; Glass, Roger; Glassman, Amanda; Gray, Glenda; Habte, Demissie; Holmes, King K.; Horton, Susan; Hutton, Guy; Jha, Prabhat; Knaul, Felicia; Kobusingye, Olive; Krakauer, Eric L.; Kruk, Margaret E.; Lachmann, Peter; Laxminarayan, Ramanan; Levin, Carol; Looi, Lai Meng; Madhav, Nita; Mahmoud, Adel; Mbanya, Jean Claude; Measham, Anthony; Medina-Mora, María Elena; Medlin, Carol; Mills, Anne; Mills, Jody Anne; Montoya, Jaime; Norheim, Ole; Olson, Zachary; Omokhodion, Folashade; Oppenheim, Ben; Ord, Toby; Patel, Vikram; Patton, George C.; Peabody, John; Prabhakaran, Dorairaj; Qi, Jinyuan; Reynolds, Teri; Ruacan, Sevket; Sankaranarayanan, Rengaswamy; Sepúlveda, Jaime; Skolnik, Richard; Smith, Kirk R.; Temmerman, Marleen; Tollman, Stephen; Verguet, Stéphane; Walker, Damian G.; Walker, Neff; Wu, Yangfeng; Zhao, Kun.

In: The Lancet, 01.01.2017.

Research output: Contribution to journalArticle

Jamison, DT, Alwan, A, Mock, CN, Nugent, R, Watkins, D, Adeyi, O, Anand, S, Atun, R, Bertozzi, S, Bhutta, Z, Binagwaho, A, Black, R, Blecher, M, Bloom, BR, Brouwer, E, Bundy, DAP, Chisholm, D, Cieza, A, Cullen, M, Danforth, K, de Silva, N, Debas, HT, Donkor, P, Dua, T, Fleming, KA, Gallivan, M, Garcia, PJ, Gawande, A, Gaziano, T, Gelband, H, Glass, R, Glassman, A, Gray, G, Habte, D, Holmes, KK, Horton, S, Hutton, G, Jha, P, Knaul, F, Kobusingye, O, Krakauer, EL, Kruk, ME, Lachmann, P, Laxminarayan, R, Levin, C, Looi, LM, Madhav, N, Mahmoud, A, Mbanya, JC, Measham, A, Medina-Mora, ME, Medlin, C, Mills, A, Mills, JA, Montoya, J, Norheim, O, Olson, Z, Omokhodion, F, Oppenheim, B, Ord, T, Patel, V, Patton, GC, Peabody, J, Prabhakaran, D, Qi, J, Reynolds, T, Ruacan, S, Sankaranarayanan, R, Sepúlveda, J, Skolnik, R, Smith, KR, Temmerman, M, Tollman, S, Verguet, S, Walker, DG, Walker, N, Wu, Y & Zhao, K 2017, 'Universal health coverage and intersectoral action for health: Key messages from Disease Control Priorities, 3rd edition', The Lancet. https://doi.org/10.1016/S0140-6736(17)32906-9
Jamison, Dean T. ; Alwan, Ala ; Mock, Charles N. ; Nugent, Rachel ; Watkins, David ; Adeyi, Olusoji ; Anand, Shuchi ; Atun, Rifat ; Bertozzi, Stefano ; Bhutta, Zulfiqar ; Binagwaho, Agnes ; Black, Robert ; Blecher, Mark ; Bloom, Barry R. ; Brouwer, Elizabeth ; Bundy, Donald A.P. ; Chisholm, Dan ; Cieza, Alarcos ; Cullen, Mark ; Danforth, Kristen ; de Silva, Nilanthi ; Debas, Haile T. ; Donkor, Peter ; Dua, Tarun ; Fleming, Kenneth A. ; Gallivan, Mark ; Garcia, Patricia J. ; Gawande, Atul ; Gaziano, Thomas ; Gelband, Hellen ; Glass, Roger ; Glassman, Amanda ; Gray, Glenda ; Habte, Demissie ; Holmes, King K. ; Horton, Susan ; Hutton, Guy ; Jha, Prabhat ; Knaul, Felicia ; Kobusingye, Olive ; Krakauer, Eric L. ; Kruk, Margaret E. ; Lachmann, Peter ; Laxminarayan, Ramanan ; Levin, Carol ; Looi, Lai Meng ; Madhav, Nita ; Mahmoud, Adel ; Mbanya, Jean Claude ; Measham, Anthony ; Medina-Mora, María Elena ; Medlin, Carol ; Mills, Anne ; Mills, Jody Anne ; Montoya, Jaime ; Norheim, Ole ; Olson, Zachary ; Omokhodion, Folashade ; Oppenheim, Ben ; Ord, Toby ; Patel, Vikram ; Patton, George C. ; Peabody, John ; Prabhakaran, Dorairaj ; Qi, Jinyuan ; Reynolds, Teri ; Ruacan, Sevket ; Sankaranarayanan, Rengaswamy ; Sepúlveda, Jaime ; Skolnik, Richard ; Smith, Kirk R. ; Temmerman, Marleen ; Tollman, Stephen ; Verguet, Stéphane ; Walker, Damian G. ; Walker, Neff ; Wu, Yangfeng ; Zhao, Kun. / Universal health coverage and intersectoral action for health : Key messages from Disease Control Priorities, 3rd edition. In: The Lancet. 2017.
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title = "Universal health coverage and intersectoral action for health: Key messages from Disease Control Priorities, 3rd edition",
abstract = "The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1{\%} of (current) gross national income (GNI) in low-income countries and 5·2{\%} of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.",
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T1 - Universal health coverage and intersectoral action for health

T2 - Key messages from Disease Control Priorities, 3rd edition

AU - Jamison, Dean T.

AU - Alwan, Ala

AU - Mock, Charles N.

AU - Nugent, Rachel

AU - Watkins, David

AU - Adeyi, Olusoji

AU - Anand, Shuchi

AU - Atun, Rifat

AU - Bertozzi, Stefano

AU - Bhutta, Zulfiqar

AU - Binagwaho, Agnes

AU - Black, Robert

AU - Blecher, Mark

AU - Bloom, Barry R.

AU - Brouwer, Elizabeth

AU - Bundy, Donald A.P.

AU - Chisholm, Dan

AU - Cieza, Alarcos

AU - Cullen, Mark

AU - Danforth, Kristen

AU - de Silva, Nilanthi

AU - Debas, Haile T.

AU - Donkor, Peter

AU - Dua, Tarun

AU - Fleming, Kenneth A.

AU - Gallivan, Mark

AU - Garcia, Patricia J.

AU - Gawande, Atul

AU - Gaziano, Thomas

AU - Gelband, Hellen

AU - Glass, Roger

AU - Glassman, Amanda

AU - Gray, Glenda

AU - Habte, Demissie

AU - Holmes, King K.

AU - Horton, Susan

AU - Hutton, Guy

AU - Jha, Prabhat

AU - Knaul, Felicia

AU - Kobusingye, Olive

AU - Krakauer, Eric L.

AU - Kruk, Margaret E.

AU - Lachmann, Peter

AU - Laxminarayan, Ramanan

AU - Levin, Carol

AU - Looi, Lai Meng

AU - Madhav, Nita

AU - Mahmoud, Adel

AU - Mbanya, Jean Claude

AU - Measham, Anthony

AU - Medina-Mora, María Elena

AU - Medlin, Carol

AU - Mills, Anne

AU - Mills, Jody Anne

AU - Montoya, Jaime

AU - Norheim, Ole

AU - Olson, Zachary

AU - Omokhodion, Folashade

AU - Oppenheim, Ben

AU - Ord, Toby

AU - Patel, Vikram

AU - Patton, George C.

AU - Peabody, John

AU - Prabhakaran, Dorairaj

AU - Qi, Jinyuan

AU - Reynolds, Teri

AU - Ruacan, Sevket

AU - Sankaranarayanan, Rengaswamy

AU - Sepúlveda, Jaime

AU - Skolnik, Richard

AU - Smith, Kirk R.

AU - Temmerman, Marleen

AU - Tollman, Stephen

AU - Verguet, Stéphane

AU - Walker, Damian G.

AU - Walker, Neff

AU - Wu, Yangfeng

AU - Zhao, Kun

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N2 - The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.

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