Publication:
Financing of Essential Public Health Services in the Caribbean Region: Case Study

Loading...
Thumbnail Image
Files in English
English PDF (19.78 MB)
244 downloads
English Text (413.85 KB)
22 downloads
Date
2023-09-21
ISSN
Published
2023-09-21
Author(s)
Marquez, Patricio V.
Theodore, Karl
Laptiste, Christine
La Foucade, Althea
Scott, Ewan
Metivier, Charmaine
Maharaj, Malini
Brizan–St. Martin, Roxanne
Gittens-Baynes, Kimberly-Ann
Editor(s)
Abstract
This study examines the expenditure by Caribbean Community (CARICOM) countries on the delivery of Essential Public Health Services (EPHS), in the context of the global response to COVID-19. In particular, the study focuses on financing arrangements enacted to ensure the predictability of funding and the sustainability in the level and flow of funds over the medium and long terms to carry out essential public health functions in Barbados, Grenada, Jamaica, and Trinidad and Tobago. The study also highlights the close, synergistic relationship between the Caribbean Public Health Agency (CARPHA) and its Member States.
Link to Data Set
Citation
Wang,Huihui; Marquez, Patricio V.; Theodore, Karl; Laptiste, Christine ; La Foucade, Althea; Scott, Ewan; Metivier, Charmaine ; Maharaj, Malini ; Brizan–St. Martin, Roxanne; Gittens-Baynes, Kimberly-Ann ; Edwards-Wescott, Patricia; Harewood, Heather; Beharry, Vyjanti. 2023. Financing of Essential Public Health Services in the Caribbean Region: Case Study. Pharmacovigilance and Essential Public Health Services Series. © World Bank. http://hdl.handle.net/10986/40381 License: CC BY-NC 3.0 IGO.
Associated URLs
Associated content
Report Series
Other publications in this report series
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    The Caribbean Regulatory System
    (World Bank, Washington, DC, 2023-08-15) Wang, Huihui; Extavour, Rian Marie; Marquez, Patricio V.; Bieliaieva, Kseniya
    This report focuses on the Caribbean Public Health Agency (CARPHA), one of the three multi-national public health agencies in the world, that commenced operations on Jan 1, 2013, with the aim of delivering the functions of five previous regional health institutions through one platform for greater synergy and cost-effectiveness and as the principal institutional expression of Caribbean Cooperation in Health. The activities of CARPHA include the provision of a subregional mechanism that supports regulatory action to ensure access to safe medicines, such as the subregional system for reporting adverse drug reactions (ADRs) and substandard and falsified products (VigiCarib), and the regional post marketing drug quality testing program under the CARPHA Medicines Quality Control and Surveillance Department. Another relevant CARPHA activity is reviewing new medicines which want to enter the Caribbean market. This was especially important during the COVID-19 pandemic, with the plethora of new vaccines. VigiCarib is a good example of a subregional approach to facilitate well-functioning post marketing monitoring activities, including PV. Although this is a relatively new program, it is well established, integrates lessons from more experienced regulatory authorities, and supports small economies without specific PV programs, thus helping ensure the safety, quality, and effectiveness of medicines and vaccines. VigiCarib can serve as a model in other parts of the world where a regional approach to strengthening regulatory systems is under consideration. However, a key lesson of the experience of CARICOM, is that regional initiatives are complex and require clear objectives, harmonization, respect for the individual countries and territories, and mutual trust.
  • Publication
    Realizing a Regional Approach to Pharmacovigilance
    (Washington, DC: World Bank, 2023-08-11) Wang, Huihui; Marquez, Patricio V.; Bieliaieva, Kseniya
    This report reviews the pharmacovigilance system of the European Union (EU) mapping out its structure and processes with any eye to features that may be of particular interest to decision makers in other regions as they weigh options related to creating a regional pharmacovigilance architecture for themselves. It begins with a review of the European Medicines Agency (EMA), which plays a central role in the EU system, followed by an overview of the EU PV assessment and monitoring process and an example of the system in action regarding COVID-19 vaccines. It concludes with a summary several key insights of particular relevance for decision makers.
  • Publication
    The Value of Pharmacovigilance in Building Resilient Health Systems Post-COVID
    (World Bank, Washington, DC, 2023-08-15) Wang,Huihui; Marquez,Patricio V.; Figueras Sune,Albert-Jesus; Kseniya Bieliaieva
    Although indispensable for improving health outcomes, medicines and vaccines or their administration and use can produce adverse effects, requiring continuous vigilance to ensure that the benefits outweigh the risks. Monitoring the safety of the use of marketed medicines and vaccines, also known as pharmacovigilance, should therefore become much more explicit in efforts to strengthen health systems and prepare for public health crises and normal times because the world is determined to build back better after the COVID-19 pandemic.  The objective of this report is to examine the importance of pharmacovigilance in a health system both during a health crisis and in normal times, describe the function, structure, and processes of a functional pharmacovigilance system, and explain the value of drug safety monitoring in building resilience in health systems post-COVID-19 pandemic. 
  • Publication
    Why is the Safety of Medicines Important for Resilient Health Systems? A Synthesis Report
    (Washington, DC: World Bank, 2023-08-22) Wang, Huihui; Marquez, Patricio V.; Figueras, Albert; Bieliaieva, Kseniya
    This report discusses the importance of pharmacovigilance (PV) in contributing to building up resilient health systems. It is based on and summarizes the findings of a review of available literature on the topic and relevant case studies focusing on a set of country and regional experiences. Although indispensable in improving health outcomes, the administration and use of medicines may produce adverse reactions, requiring continuous monitoring to ensure that the benefits outweigh the risks. PV, which involves the systematic detection, reporting, assessment, understanding, and prevention of adverse drug reactions (ADRs), is an essential public health function, but it is often overlooked. The review suggests that successful PV programs are built on three essential pillars: statutory provisions that establish standards for PV centers and programs, well-trained health professionals and associated stakeholders, and engaged PV reporters using effective reporting systems. These pillars allow PV programs to be effective in three core activities: reporting adverse drug events (ADEs) and identifying signals, determining threats through a benefit-risk balance analysis, and taking appropriate actions. This is in addition to supporting various functions of a health system, such as national drug policy and regulation, the delivery of medical care, specific disease control programs, increasing the trust of the general public in the system, and promoting eco-PV. Aided by emerging opportunities for development through automation and machine learning, PV programs show immense potential to enhance the monitoring of patient safety and improve the use of medicines. The report offers policy considerations for countries and international partners in building PV capacity as an essential public function of a health system.
  • Publication
    Learning from the Republic of Korea
    (World Bank, Washington, DC, 2023-08-15) Wang, Huihui; Hwang, Inuk; Marquez, Patricio V.
    The response of the government of the Republic of Korea to COVID-19 has been heralded as among the most successful. In the first two years of the pandemic, the government was able to keep the size of the outbreak relatively small and the death toll relatively low. Although the number of COVID-19 cases jumped significantly subsequently in 2022 and 2023 due to the spread of the more transmissible Omicron variant and a revamped testing regime that cast a broader net to detect infections, Korea had a much lower rate of total confirmed COVID-19 deaths per million population than other high income countries (676 in Korea, as compared to 3,379 in the United Kingdom, 3,331 in the United States, and 2,599 in France). The government achieved this relatively positive result without resorting to the highly restrictive measures that were adopted by most high-income countries, such as strictly controlling borders, shuttering businesses, or issuing severe lockdown or stay-at-home orders. Indeed, since the start of the outbreak in January 2020, the distinguishing features of the response in Korea include the government’s ability to mobilize swiftly, even in the early stages of the pandemic, to flatten the epidemic curve. This report dissects the COVID-19 countermeasures successfully adopted in Korea. The analysis draws out insights and lessons that may be relevant to other countries as they mount responses to ongoing crises and prepare for future public health emergencies.

Users also downloaded

Showing related downloaded files

  • Publication
    Kosovo : Economic and Social Reforms for Peace and Reconciliation
    (Washington, DC, 2001-05) World Bank
    The report discusses the principal economic, and social reform policy tasks, Kosovo is facing, following the decade-long losses due to civic exclusion of a major part of its ethnic population, the absence of investments, and the neglect of physical, and human capital, a period which culminated in the 1999 conflict. It intends to inform on the framework of the United Nations Interim Administration in Kosovo, i.e., the consolidation of peace, by fostering social reconciliation, towards achieving sustainable economic growth in the province. The key challenges to the political economy address: 1) the formulation of a sustainable budget, increasingly financed through local taxation, hence, with reduced reliance on external donor support. Fiscal institutions need to be developed to ensure efficient public spending; 2) the establishment of trade liberalization, and a customs regime, to increase the potential for growth, and exports, allowing as well to benefit from the arrangements fostered by the Stability Pact, and the European Union; 3) the use of hard currency for internal transactions, and savings, and, the development of a strategy for banking sector development; and, 4) the creation of a reformed framework to encourage growth, by stimulating private enterprise development. Moreover, three aspects of social policy call for: an education policy at par with competitor countries; health policy that strengthens health care delivery, and addresses the effects of recent social traumas; and, social protection regarding a highly vulnerable population.
  • Publication
    Slovak Republic : Living Standards, Employment, and Labor Market Study
    (Washington, DC, 2001-08-09) World Bank
    By most indicators the Slovak Republic has achieved a high level of human and social development. Despite the country's generally high living standards and overall level of development, there are families in Slovakia whose living conditions are below what is considered to be socially acceptable. By societal standards, these families and individuals are poor. The objective of this study is to analyze this poverty, so as to help design measures and policies to reduce it. The study also seeks to understand the phenomenon of unemployment--the main cause of poverty--and propose actions to alleviate it. The report is organized as follows: After Chapter 1, which explains the background of poverty and inequality in the Slovak Republic, Chapter 2 addresses the challenge of generating employment, including rising unemployment and inactivity, job reallocation during transition, the importance of the regional and skills mismatch, and conclusions and policy recommendations that enhance employment creation. Chapter 3 explores the role of the safety net system, particularly unemployment insurance and other forms of social assistance; presents a brief simulation analysis of the disincentives provided by unemployment insurance, social assistance, and social support; provides an empirical analysis of disincentive effects; and ends with a discussion of the policy implications. Chapter 4 focuses on the poverty and welfare of the Roma population. Finally Chapter 5 telescopes regional disparities.
  • Publication
    Timor-Leste Economic Report, December 2022
    (Washington, DC, 2022-12) World Bank
    The global economy continues to face steep challenges, but Timor-Leste’s economy is slowly recovering. Nevertheless, gross domestic product (GDP) per capita has not returned to pre-pandemic levels. Consumer price inflation reached 7.9 percent yoy in August 2022, one of the highest in the East Asia Pacific region. The real effective exchange rate (REER) has appreciated by about 10 percent since the first quarter of 2021. Enhancing productive capabilities through structural reforms and improving quality of public spending hold the key for accelerating and sustaining economic development. Extending the life of petroleum fund through fiscal consolidation is essential to delay the fiscal cliff and ensure the perpetuation of government spending to support economic growth. Despite receding impact of the pandemic, the level of government spending has not returned to the pre-COVID 19 levels.
  • Publication
    Distributed Ledger Technology and Blockchain
    (World Bank, Washington, DC, 2017) Natarajan, Harish; Krause, Solvej; Gradstein, Helen
    The financial sector is currently undergoing a major transformation, brought about by the rapid development and spread of new technologies. The confluence of ‘finance’ and ‘technology’ is often referred to as ‘Fintech’, typically describing companies or innovations that employ new technologies to improve or innovate financial services. ‘Fintech’ developments are seen across all areas of the financial sector, including payments and financial infrastructures, consumer and SMElending, insurance, investment management, and venture financing. This note on distributed ledger technology (DLT) and blockchains is part of a series of short notes that explore new trends and developments in Fintech and analyze their potential relevance for WBG activities. Forthcoming notes in this series will cover marketplace lending, ‘InsureTech’, and other topics. This note outlines the mechanisms, origins, and key characteristics of DLT; the difference between ‘public’ and ‘private’ DLT; the technology’s main advantages, challenges, and risks; relevant examples of DLT applications (with a focus on financial sector applications); and a brief overview of activities by governments, multilateral organization, and other stakeholders in this space. Finally, this note proposes next steps for the World Bank to study and evaluate areas where DLT could potentially be integrated into World Bank financial sector operations.
  • Publication
    World Development Report 2014
    (Washington, DC, 2013-10-06) World Bank
    The past 25 years have witnessed unprecedented changes around the world—many of them for the better. Across the continents, many countries have embarked on a path of international integration, economic reform, technological modernization, and democratic participation. As a result, economies that had been stagnant for decades are growing, people whose families had suffered deprivation for generations are escaping poverty, and hundreds of millions are enjoying the benefits of improved living standards and scientific and cultural sharing across nations. As the world changes, a host of opportunities arise constantly. With them, however, appear old and new risks, from the possibility of job loss and disease to the potential for social unrest and environmental damage. If ignored, these risks can turn into crises that reverse hard-won gains and endanger the social and economic reforms that produced these gains. The World Development Report 2014 (WDR 2014), Risk and Opportunity: Managing Risk for Development, contends that the solution is not to reject change in order to avoid risk but to prepare for the opportunities and risks that change entails. Managing risks responsibly and effectively has the potential to bring about security and a means of progress for people in developing countries and beyond. Although individuals’ own efforts, initiative, and responsibility are essential for managing risk, their success will be limited without a supportive social environment—especially when risks are large or systemic in nature. The WDR 2014 argues that people can successfully confront risks that are beyond their means by sharing their risk management with others. This can be done through naturally occurring social and economic systems that enable people to overcome the obstacles that individuals and groups face, including lack of resources and information, cognitive and behavioral failures, missing markets and public goods, and social externalities and exclusion. These systems—from the household and the community to the state and the international community—have the potential to support people’s risk management in different yet complementary ways. The Report focuses on some of the most pressing questions policy makers are asking. What role should the state take in helping people manage risks? When should this role consist of direct interventions, and when should it consist of providing an enabling environment? How can governments improve their own risk management, and what happens when they fail or lack capacity, as in many fragile and conflict-affected states? Through what mechanisms can risk management be mainstreamed into the development agenda? And how can collective action failures to manage systemic risks be addressed, especially those with irreversible consequences? The WDR 2014 provides policy makers with insights and recommendations to address these difficult questions. It should serve to guide the dialogue, operations, and contributions from key development actors—from civil society and national governments to the donor community and international development organizations.