COUNTRY-LEVEL
DECISION MAKING
FOR CONTROL OF
CHRONIC DISEASES
Workshop Summary
Alexandra Beatty, Rapporteur
Board on Global Health
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This project was supported by funds from private donors. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the individuals or organizations that provided support for this project.
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Suggested citation: IOM (Institute of Medicine). 2012. Country-Level Decision Making for Control of Chronic Diseases: Workshop Summary. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”—Goethe
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
PLANNING COMMITTEE FOR A WORKSHOP ON DEFINING COUNTRY-LEVEL RESOURCE NEEDS FOR CARDIOVASCULAR DISEASE AND RELATED CHRONIC DISEASES1
RACHEL NUGENT (Chair), University of Washington
KALIPSO CHALKIDOU, National Institute for Health and Clinical Excellence, United Kingdom
VALENTÍN FUSTER, Mount Sinai Heart
STEPHEN JAN, George Institute for Global Health
PETER LAMPTEY, FHI360
DEREK YACH, PepsiCo
Project Staff
BRIDGET B. KELLY, Project Director/Senior Program Officer
COLLIN WEINBERGER, Research Associate
RACHEL PITTLUCK, Senior Program Assistant (through April 2011)
LEIGH CARROLL, Senior Program Assistant (from April 2011)
JULIE WILTSHIRE, Financial Associate
PATRICK KELLEY, Director, Board on Global Health
____________
1 Institute of Medicine planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
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Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:
Amanda Glassman, Center for Global Development
Paul Holmes, USAID
J. Jaime Miranda, Universidad Peruana Cayetano Heredia, Peru
Rachel Nugent, University of Washington
Theo Vos, University of Queensland, Australia
Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the report before its release. The review of this report was overseen by David R. Challoner, Emeritus, University of Florida. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the rapporteur and the institution.
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Acknowledgments
The planning committee and project staff are deeply appreciative of the many valuable contributions from those who assisted us with this project. We offer our profound thanks to the presenters and discussants at the workshop, who gave so generously of their time and expertise. These individuals are listed in full in Appendix A. We are also grateful to the many participants who attended the workshop both in person and via the live webcast. The robust engagement of everyone in attendance was vital to the success of the event.
During the planning of the workshop, we benefited enormously from input from Dan Chisholm, Tom Gaziano, Amanda Glassman, Louis Niessen, and Theo Vos, as well as from representatives of the UnitedHealth/National Heart, Lung, and Blood Institute Centers of Excellence, who provided valuable perspectives, feedback, and suggestions when they very graciously included us in their April 2011 meeting.
A number of individuals contributed to the administrative and logistical success of this project. For their patience and assistance facilitating scheduling and communication with the planning committee, we are grateful to Julia Addae-Mintah, Derek Cutler, Josie Kummer, and Jennifer Tsai. In addition, we extend many thanks to Anthony Mavrogiannis and the staff at Kentlands Travel for supporting the travel needs and requirements of this project. We thank Cornelia Lluberes for her help with logistics at the workshop during her summer internship. We also convey our gratitude for the hard work of the many other staff of the Institute of Medicine and the National Academies who supported the project at every stage. In particular, we greatly appreciate the work of Kathleen C. Ostapkovich, who assisted
with various aspects of the workshop during her time as a summer Research Associate.
Finally, we are grateful for the tremendous generosity of the individual donors who made this workshop possible through their contributions to a fund that supports dissemination and follow-up activities for the 2010 Institute of Medicine report, Promoting Cardiovascular Health in the Developing World.
Contents
2 Progress, Needs, and Lessons Learned: Perspectives from Six Countries
3 Data Availability and Gaps in Four Countries
4 Examples of Tools for Costing, Economic Modeling, and Priority Setting
5 Approaches to Supporting Country-Led Action
6 Summary of Considerations for Developing a Toolkit for Country-Led Decision Making
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BMI |
body mass index |
CDC |
U.S. Centers for Disease Control and Prevention |
DALY |
disability-adjusted life year |
EVIDEM |
Evidence and Value: Impact on Decision Making |
GDP |
gross domestic product |
HIV/AIDS |
human immunodeficiency virus/acquired immune deficiency syndrome |
INDEPTH |
International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries |
LiST |
Lives Saved Tool |
MCDA |
multi-criteria decision analysis |
NCD |
noncommunicable disease |
NGO |
nongovernmental organization |
NHLBI |
National Heart, Lung, and Blood Institute |
UN |
United Nations |
UNFPA |
United Nations Population Fund |
USAID |
U.S. Agency for International Development |
WHO |
World Health Organization |
WHO-CHOICE |
CHOosing Interventions that are Cost Effective (WHO) |
WHO-STEPS |
STEPwise approach to Surveillance (WHO) |