so I had a baby recently and I have to admit I found it to be quite an
admit I found it to be quite an
admit I found it to be quite an undertaking I’m sure many of you today
undertaking I’m sure many of you today
undertaking I’m sure many of you today here in the room can relate
here in the room can relate
here in the room can relate first there’s the timing of the entire
first there’s the timing of the entire
first there’s the timing of the entire thing do I wait until my PhD is finished
thing do I wait until my PhD is finished
thing do I wait until my PhD is finished but then and I’m not getting too old and
but then and I’m not getting too old and
but then and I’m not getting too old and then when I was pregnant how and when do
then when I was pregnant how and when do
then when I was pregnant how and when do I tell the news to friends and family
I tell the news to friends and family
I tell the news to friends and family and how and when to tell my boss who I
and how and when to tell my boss who I
and how and when to tell my boss who I expected to be less excited
expected to be less excited
expected to be less excited should I get a bigger car bigger house
should I get a bigger car bigger house
should I get a bigger car bigger house what sort of daycare shall we go to and
what sort of daycare shall we go to and
what sort of daycare shall we go to and sort of stuff do you need to buy for a
sort of stuff do you need to buy for a
sort of stuff do you need to buy for a baby how should we name there may be
baby how should we name there may be
baby how should we name there may be many questions and then there was all
many questions and then there was all
many questions and then there was all the googling I’m an extreme
the googling I’m an extreme
the googling I’m an extreme hypochondriac so I knew in every single
hypochondriac so I knew in every single
hypochondriac so I knew in every single week of the pregnancy which organs were
week of the pregnancy which organs were
week of the pregnancy which organs were being developed but I also know in every
being developed but I also know in every
being developed but I also know in every single week how that could go terribly
single week how that could go terribly
single week how that could go terribly wrong so you can imagine by the time the
wrong so you can imagine by the time the
wrong so you can imagine by the time the baby was due I was already completely
baby was due I was already completely
baby was due I was already completely exhausted now at no point in this
exhausted now at no point in this
exhausted now at no point in this process did I have to worry about not
process did I have to worry about not
process did I have to worry about not being able to go to the doctor when I
being able to go to the doctor when I
being able to go to the doctor when I had to actually all the googling let me
had to actually all the googling let me
had to actually all the googling let me just see the doctor a few times too many
just see the doctor a few times too many
just see the doctor a few times too many and while I was concerned about the
and while I was concerned about the
and while I was concerned about the bills of all the unnecessary overpriced
bills of all the unnecessary overpriced
bills of all the unnecessary overpriced baby stuff that I bought I never worried
baby stuff that I bought I never worried
baby stuff that I bought I never worried about the medical bills and I guess
about the medical bills and I guess
about the medical bills and I guess that’s true for most of you here right
that’s true for most of you here right
that’s true for most of you here right we never really worried about not
we never really worried about not
we never really worried about not getting the care we need or not being
getting the care we need or not being
getting the care we need or not being able to pay for it now not everyone is
able to pay for it now not everyone is
able to pay for it now not everyone is so lucky for many women in a developing
so lucky for many women in a developing
so lucky for many women in a developing world
world
world becoming pregnant is really scary many
becoming pregnant is really scary many
becoming pregnant is really scary many of them have to give birth at home alone
of them have to give birth at home alone
of them have to give birth at home alone without a doctor or nurse there to help
without a doctor or nurse there to help
without a doctor or nurse there to help they can’t afford going to nice private
they can’t afford going to nice private
they can’t afford going to nice private clinics because all these are too
clinics because all these are too
clinics because all these are too expensive and they often don’t want to
expensive and they often don’t want to
expensive and they often don’t want to go to the cheaper public ones because
go to the cheaper public ones because
go to the cheaper public ones because these are overcrowded not clean short on
these are overcrowded not clean short on
these are overcrowded not clean short on staff and supplies also the doctors who
staff and supplies also the doctors who
staff and supplies also the doctors who work there often don’t do what they’re
work there often don’t do what they’re
work there often don’t do what they’re supposed to you know that in quite some
supposed to you know that in quite some
supposed to you know that in quite some developing countries you’re unlikely to
developing countries you’re unlikely to
developing countries you’re unlikely to get your blood pressure checked when you
get your blood pressure checked when you
get your blood pressure checked when you go for a prenatal visit a very simple
go for a prenatal visit a very simple
go for a prenatal visit a very simple way to assess risk for preterm delivery
way to assess risk for preterm delivery
way to assess risk for preterm delivery and then when you do end up delivering
and then when you do end up delivering
and then when you do end up delivering enough
enough
enough facility you might have a hard time
facility you might have a hard time
facility you might have a hard time leaving me tester here
leaving me tester here
leaving me tester here a new mother in Kenya who is being kept
a new mother in Kenya who is being kept
a new mother in Kenya who is being kept hostage in the hospital with her baby
hostage in the hospital with her baby
hostage in the hospital with her baby for over two months simply because she
for over two months simply because she
for over two months simply because she couldn’t afford to pay the bill now the
couldn’t afford to pay the bill now the
couldn’t afford to pay the bill now the doctors that work in this clinic they
doctors that work in this clinic they
doctors that work in this clinic they have to earn their income from people’s
have to earn their income from people’s
have to earn their income from people’s out-of-pocket payments so they keep her
out-of-pocket payments so they keep her
out-of-pocket payments so they keep her there until someone pays as a result of
there until someone pays as a result of
there until someone pays as a result of this lack of access to basic healthcare
this lack of access to basic healthcare
this lack of access to basic healthcare many women die and many children die too
many women die and many children die too
many women die and many children die too actually they die from diseases like
actually they die from diseases like
actually they die from diseases like diarrhea pneumonia diseases which are
diarrhea pneumonia diseases which are
diarrhea pneumonia diseases which are very easy to treat or prevent every
very easy to treat or prevent every
very easy to treat or prevent every single day
single day
single day 17,000 women and children die almost all
17,000 women and children die almost all
17,000 women and children die almost all of them in developing countries and
of them in developing countries and
of them in developing countries and almost all of them could be avoided
almost all of them could be avoided
almost all of them could be avoided 17,000 that’s a lot that’s like a whole
17,000 that’s a lot that’s like a whole
17,000 that’s a lot that’s like a whole city every single month why why is this
city every single month why why is this
city every single month why why is this why can’t we get those often very simple
why can’t we get those often very simple
why can’t we get those often very simple cheap interventions deliver to those who
cheap interventions deliver to those who
cheap interventions deliver to those who need them well I think that’s because we
need them well I think that’s because we
need them well I think that’s because we focus too much on specific diseases
focus too much on specific diseases
focus too much on specific diseases developing new cures for HIV AIDS
developing new cures for HIV AIDS
developing new cures for HIV AIDS malaria tuberculosis Ebola and then
malaria tuberculosis Ebola and then
malaria tuberculosis Ebola and then trying to get those cures delivered to
trying to get those cures delivered to
trying to get those cures delivered to poor countries but we ignore to cure the
poor countries but we ignore to cure the
poor countries but we ignore to cure the healthcare systems you know in many
healthcare systems you know in many
healthcare systems you know in many countries the way we deliver healthcare
countries the way we deliver healthcare
countries the way we deliver healthcare is broken and it’s these broken systems
is broken and it’s these broken systems
is broken and it’s these broken systems that allow all these people to die it’s
that allow all these people to die it’s
that allow all these people to die it’s these broken systems that don’t manage
these broken systems that don’t manage
these broken systems that don’t manage to get these simple drugs and vaccines
to get these simple drugs and vaccines
to get these simple drugs and vaccines delivered to those who need them so
delivered to those who need them so
delivered to those who need them so today I want to show you how we can
today I want to show you how we can
today I want to show you how we can change that and how we can start curing
change that and how we can start curing
change that and how we can start curing health care systems now this topic is
health care systems now this topic is
health care systems now this topic is not so sexy like eradicating hiv/aids
not so sexy like eradicating hiv/aids
not so sexy like eradicating hiv/aids malaria Ebola so it often doesn’t rank
malaria Ebola so it often doesn’t rank
malaria Ebola so it often doesn’t rank high on the policy agenda but I think
high on the policy agenda but I think
high on the policy agenda but I think that should be changed because the way
that should be changed because the way
that should be changed because the way we organize health get and especially
we organize health get and especially
we organize health get and especially the way we pay doctors is crucial in
the way we pay doctors is crucial in
the way we pay doctors is crucial in defining where they are and what they do
defining where they are and what they do
defining where they are and what they do and that’s not only true in developing
and that’s not only true in developing
and that’s not only true in developing countries actually I mean
countries actually I mean
countries actually I mean financial incentives shaped doctor’s
financial incentives shaped doctor’s
financial incentives shaped doctor’s behavior everywhere I myself experienced
behavior everywhere I myself experienced
behavior everywhere I myself experienced it when I gave birth to my son this is
it when I gave birth to my son this is
it when I gave birth to my son this is my son bus oh very cute very beautiful
my son bus oh very cute very beautiful
my son bus oh very cute very beautiful baby boy mmm
baby boy mmm
baby boy mmm despite all the stress I just told you
despite all the stress I just told you
despite all the stress I just told you about from the medical perspective I had
about from the medical perspective I had
about from the medical perspective I had a very smooth and easy pregnancy and
a very smooth and easy pregnancy and
a very smooth and easy pregnancy and delivery there were no complications
delivery there were no complications
delivery there were no complications still I stayed in a hospital in Belgium
still I stayed in a hospital in Belgium
still I stayed in a hospital in Belgium where I live and what I have my health
where I live and what I have my health
where I live and what I have my health insurance for four days after giving
insurance for four days after giving
insurance for four days after giving birth now everything was going well you
birth now everything was going well you
birth now everything was going well you can imagine those four days they’re
can imagine those four days they’re
can imagine those four days they’re filled with eating chocolate sipping
filled with eating chocolate sipping
filled with eating chocolate sipping champagne having friends and family
champagne having friends and family
champagne having friends and family reading magazines during the very long
reading magazines during the very long
reading magazines during the very long and numerous breastfeeding sessions
and numerous breastfeeding sessions
and numerous breastfeeding sessions there’s one particular magazine cover
there’s one particular magazine cover
there’s one particular magazine cover they really shocked me and it’s this one
they really shocked me and it’s this one
they really shocked me and it’s this one with Kate Middleton and baby George on
with Kate Middleton and baby George on
with Kate Middleton and baby George on the cover gates give birth around the
the cover gates give birth around the
the cover gates give birth around the same time as I did but she left the
same time as I did but she left the
same time as I did but she left the hospital on the same day of delivery
hospital on the same day of delivery
hospital on the same day of delivery with Prince George or she looked like
with Prince George or she looked like
with Prince George or she looked like this pretty amazing
now I know there’s many differences
now I know there’s many differences between Kate and I and I didn’t look
between Kate and I and I didn’t look
between Kate and I and I didn’t look half as elegant even four weeks after
half as elegant even four weeks after
half as elegant even four weeks after giving birth but I mean having
giving birth but I mean having
giving birth but I mean having pregnancies and delivery it’s not easier
pregnancies and delivery it’s not easier
pregnancies and delivery it’s not easier or shorter for Royals than it is for me
or shorter for Royals than it is for me
or shorter for Royals than it is for me so why are we treated so differently why
so why are we treated so differently why
so why are we treated so differently why do I need to stay in the hospital for so
do I need to stay in the hospital for so
do I need to stay in the hospital for so much longer well the difference is in
much longer well the difference is in
much longer well the difference is in the way health get is being financed in
the way health get is being financed in
the way health get is being financed in Belgium hospitals are are reimbursed for
Belgium hospitals are are reimbursed for
Belgium hospitals are are reimbursed for delivery care on the basis of the actual
delivery care on the basis of the actual
delivery care on the basis of the actual bills so whatever service they provide
bills so whatever service they provide
bills so whatever service they provide they get reimbursed in the UK hospitals
they get reimbursed in the UK hospitals
they get reimbursed in the UK hospitals are reimbursed a fixed amount for
are reimbursed a fixed amount for
are reimbursed a fixed amount for delivery care so they are having women
delivery care so they are having women
delivery care so they are having women stay longer in the hospital generates
stay longer in the hospital generates
stay longer in the hospital generates lots of additional costs you see the
lots of additional costs you see the
lots of additional costs you see the financial incentives method for doctors
financial incentives method for doctors
financial incentives method for doctors behavior the way we finance delivery
behavior the way we finance delivery
behavior the way we finance delivery care in Belgium generates waste and I
care in Belgium generates waste and I
care in Belgium generates waste and I realize me staying in a hospital in
realize me staying in a hospital in
realize me staying in a hospital in Belgium a few days longer than necessary
Belgium a few days longer than necessary
Belgium a few days longer than necessary doesn’t compare to actually being kept
doesn’t compare to actually being kept
doesn’t compare to actually being kept hostage in Kenya are not receiving
hostage in Kenya are not receiving
hostage in Kenya are not receiving essential health care elsewhere but the
essential health care elsewhere but the
essential health care elsewhere but the problem is that waste because of
problem is that waste because of
problem is that waste because of perverse financial incentives can be
perverse financial incentives can be
perverse financial incentives can be found in even the poorest settings take
found in even the poorest settings take
found in even the poorest settings take India for example India is home to 20%
India for example India is home to 20%
India for example India is home to 20% of the child deaths worldwide a major
of the child deaths worldwide a major
of the child deaths worldwide a major cause of these deaths is diarrhoea
cause of these deaths is diarrhoea
cause of these deaths is diarrhoea simple childhood diarrhoea can be very
simple childhood diarrhoea can be very
simple childhood diarrhoea can be very easily treated by giving the child
easily treated by giving the child
easily treated by giving the child autorotation salts this simple recipe
autorotation salts this simple recipe
autorotation salts this simple recipe here has the potential to save thousands
here has the potential to save thousands
here has the potential to save thousands of lives every year and this is simple
of lives every year and this is simple
of lives every year and this is simple right you can make this at home now
right you can make this at home now
right you can make this at home now researchers have shown that if you ask
researchers have shown that if you ask
researchers have shown that if you ask medical providers in Bihar rural India
medical providers in Bihar rural India
medical providers in Bihar rural India the majority of them know or where else
the majority of them know or where else
the majority of them know or where else is most effective and they said they
is most effective and they said they
is most effective and they said they would prescribe it for children with
would prescribe it for children with
would prescribe it for children with diarrhoea
diarrhoea
diarrhoea in reality though less than 20% of them
in reality though less than 20% of them
in reality though less than 20% of them were found to actually prescribe ORS to
were found to actually prescribe ORS to
were found to actually prescribe ORS to real patients and while less than 20% of
real patients and while less than 20% of
real patients and while less than 20% of them said that they would prescribe
them said that they would prescribe
them said that they would prescribe antibiotics which are
antibiotics which are
antibiotics which are usually not necessary and often even
usually not necessary and often even
usually not necessary and often even harmful in reality more than 70% of them
harmful in reality more than 70% of them
harmful in reality more than 70% of them did prescribe them for real patients you
did prescribe them for real patients you
did prescribe them for real patients you see poor people’s money is being wasted
see poor people’s money is being wasted
see poor people’s money is being wasted on drugs they don’t need and at the same
on drugs they don’t need and at the same
on drugs they don’t need and at the same time they don’t receive the most
time they don’t receive the most
time they don’t receive the most effective treatment so why why do
effective treatment so why why do
effective treatment so why why do doctors fail what they obviously seem to
doctors fail what they obviously seem to
doctors fail what they obviously seem to know is good medical practice again part
know is good medical practice again part
know is good medical practice again part of the reason are the financial
of the reason are the financial
of the reason are the financial incentives in India like in many
incentives in India like in many
incentives in India like in many developing countries actually doctors
developing countries actually doctors
developing countries actually doctors earn additional income from selling
earn additional income from selling
earn additional income from selling drugs so it’s no wonder that they often
drugs so it’s no wonder that they often
drugs so it’s no wonder that they often prescribe them when it’s really not
prescribe them when it’s really not
prescribe them when it’s really not necessary the question then becomes can
necessary the question then becomes can
necessary the question then becomes can we use financial incentives or can we
we use financial incentives or can we
we use financial incentives or can we change them in such way that we get
change them in such way that we get
change them in such way that we get doctors motivated to do a better job and
doctors motivated to do a better job and
doctors motivated to do a better job and there’s pretty good evidence that we can
there’s pretty good evidence that we can
there’s pretty good evidence that we can Rwanda was one of the first developing
Rwanda was one of the first developing
Rwanda was one of the first developing countries to experiment with pay for
countries to experiment with pay for
countries to experiment with pay for performance in health care in response
performance in health care in response
performance in health care in response to problems of low quality low use of
to problems of low quality low use of
to problems of low quality low use of public primary care the government
public primary care the government
public primary care the government decided to change the way it was
decided to change the way it was
decided to change the way it was financing health care so rather than
financing health care so rather than
financing health care so rather than paying facilities a fixed budget or
paying facilities a fixed budget or
paying facilities a fixed budget or doctors a fixed salary irrespective of
doctors a fixed salary irrespective of
doctors a fixed salary irrespective of whether they were actually there or not
whether they were actually there or not
whether they were actually there or not doing something the government started
doing something the government started
doing something the government started to the wards facilities and doctors for
to the wards facilities and doctors for
to the wards facilities and doctors for actually providing good service so they
actually providing good service so they
actually providing good service so they agreed on a set of 14 service indicators
agreed on a set of 14 service indicators
agreed on a set of 14 service indicators mostly in relation to maternal and child
mostly in relation to maternal and child
mostly in relation to maternal and child health and they agreed on a price per
health and they agreed on a price per
health and they agreed on a price per service facilities then had to report
service facilities then had to report
service facilities then had to report monthly data on their performance and
monthly data on their performance and
monthly data on their performance and these reports were verified by external
these reports were verified by external
these reports were verified by external auditors and also information on the
auditors and also information on the
auditors and also information on the quality of care was collected and used
quality of care was collected and used
quality of care was collected and used in the calculation of the budget that
in the calculation of the budget that
in the calculation of the budget that went to facilities now what happens
went to facilities now what happens
went to facilities now what happens pretty impressive the rates of
pretty impressive the rates of
pretty impressive the rates of institutional deliveries went up by 23%
institutional deliveries went up by 23%
institutional deliveries went up by 23% and the rate of preventive care visits
and the rate of preventive care visits
and the rate of preventive care visits for children think vaccinations
for children think vaccinations
for children think vaccinations increased by more than 50% and really
increased by more than 50% and really
increased by more than 50% and really the only thing that changed here were
the only thing that changed here were
the only thing that changed here were the financial incentives the total
the financial incentives the total
the financial incentives the total budget didn’t go
budget didn’t go
budget didn’t go was kept the same so this is pretty
was kept the same so this is pretty
was kept the same so this is pretty impressive and these results have been
impressive and these results have been
impressive and these results have been stimulated many donors and countries in
stimulated many donors and countries in
stimulated many donors and countries in sub-saharan Africa to experiment with
sub-saharan Africa to experiment with
sub-saharan Africa to experiment with pay-for-performance in health care I
pay-for-performance in health care I
pay-for-performance in health care I think that’s great but we have to be a
think that’s great but we have to be a
think that’s great but we have to be a bit careful pay-for-performance it’s not
bit careful pay-for-performance it’s not
bit careful pay-for-performance it’s not a magic bullet it’s it’s quite costly
a magic bullet it’s it’s quite costly
a magic bullet it’s it’s quite costly and difficult to really monitor and
and difficult to really monitor and
and difficult to really monitor and reward good performance in healthcare
reward good performance in healthcare
reward good performance in healthcare but still even with the imperfect
but still even with the imperfect
but still even with the imperfect measures we have the one an example
measures we have the one an example
measures we have the one an example shows that simply changing the incentive
shows that simply changing the incentive
shows that simply changing the incentive structure can have big impact on the
structure can have big impact on the
structure can have big impact on the services that are being delivered now
services that are being delivered now
services that are being delivered now measuring the impact of these type of
measuring the impact of these type of
measuring the impact of these type of reforms is what I do is what my research
reforms is what I do is what my research
reforms is what I do is what my research is about it’s funny because I used to
is about it’s funny because I used to
is about it’s funny because I used to always think I’d grow up to become a
always think I’d grow up to become a
always think I’d grow up to become a doctor a real medical doctor
doctor a real medical doctor
doctor a real medical doctor and work in Africa somewhere I guess
and work in Africa somewhere I guess
and work in Africa somewhere I guess that’s related to my hypochondria and
that’s related to my hypochondria and
that’s related to my hypochondria and the strong sense of justice that I’ve
the strong sense of justice that I’ve
the strong sense of justice that I’ve always had
always had
always had I became an economist working from the
I became an economist working from the
I became an economist working from the Netherlands quite a difference and I
Netherlands quite a difference and I
Netherlands quite a difference and I have to say for a long time I regretted
have to say for a long time I regretted
have to say for a long time I regretted not having become an actual medical
not having become an actual medical
not having become an actual medical doctor but now increasingly I think
doctor but now increasingly I think
doctor but now increasingly I think perhaps I can save just as much poor
perhaps I can save just as much poor
perhaps I can save just as much poor people’s lives by curing healthcare
people’s lives by curing healthcare
people’s lives by curing healthcare systems rather than curing actual
systems rather than curing actual
systems rather than curing actual patients and I want to stress that
patients and I want to stress that
patients and I want to stress that curing a healthcare system doesn’t
curing a healthcare system doesn’t
curing a healthcare system doesn’t necessarily mean getting doctors to
necessarily mean getting doctors to
necessarily mean getting doctors to provide more in many countries now
provide more in many countries now
provide more in many countries now especially Asia the challenges how to
especially Asia the challenges how to
especially Asia the challenges how to get doctors to do less to provide less
get doctors to do less to provide less
get doctors to do less to provide less antibiotics and less IV fluids China for
antibiotics and less IV fluids China for
antibiotics and less IV fluids China for example has provided health insurance to
example has provided health insurance to
example has provided health insurance to a billion of its rural population in a
a billion of its rural population in a
a billion of its rural population in a very short period of time this is great
very short period of time this is great
very short period of time this is great but they didn’t think carefully about
but they didn’t think carefully about
but they didn’t think carefully about the way they were paying their doctors
the way they were paying their doctors
the way they were paying their doctors these were compensated very generously
these were compensated very generously
these were compensated very generously for whatever service they provides think
for whatever service they provides think
for whatever service they provides think of Belgium so as a result now many
of Belgium so as a result now many
of Belgium so as a result now many Chinese are hooked to IV fluids and are
Chinese are hooked to IV fluids and are
Chinese are hooked to IV fluids and are getting prescribed antibiotics while
getting prescribed antibiotics while
getting prescribed antibiotics while it’s really not necessary again waste
it’s really not necessary again waste
it’s really not necessary again waste because of perverse financial incentives
because of perverse financial incentives
because of perverse financial incentives now speaking of waste this is me and my
now speaking of waste this is me and my
now speaking of waste this is me and my family again this is a on the third day
family again this is a on the third day
family again this is a on the third day after I give birth to my son we’re
after I give birth to my son we’re
after I give birth to my son we’re watching the Tour of Flanders major
watching the Tour of Flanders major
watching the Tour of Flanders major Belgium cycling event of the year now
Belgium cycling event of the year now
Belgium cycling event of the year now you see while Kate was looking all
you see while Kate was looking all
you see while Kate was looking all glamorous doing photo shoots I was still
glamorous doing photo shoots I was still
glamorous doing photo shoots I was still in my pajamas on the hospital bed
in my pajamas on the hospital bed
in my pajamas on the hospital bed watching TV with my family no one is
watching TV with my family no one is
watching TV with my family no one is paying attention to the baby anymore now
paying attention to the baby anymore now
paying attention to the baby anymore now recently the Belgian Minister of Health
recently the Belgian Minister of Health
recently the Belgian Minister of Health introduced a financial penalty for
introduced a financial penalty for
introduced a financial penalty for hospitals if their average length of
hospitals if their average length of
hospitals if their average length of stay for a delivery exceeds three days
stay for a delivery exceeds three days
stay for a delivery exceeds three days it provoked quite some protest for me it
it provoked quite some protest for me it
it provoked quite some protest for me it would have meant watching the cycling
would have meant watching the cycling
would have meant watching the cycling from home rather than from the hospital
from home rather than from the hospital
from home rather than from the hospital bed which is a very small price to pay
bed which is a very small price to pay
bed which is a very small price to pay to save the Belgian system an estimated
to save the Belgian system an estimated
to save the Belgian system an estimated 33 million euros a year money that we
33 million euros a year money that we
33 million euros a year money that we can spend on other things for example
can spend on other things for example
can spend on other things for example reimbursing this new non-invasive
reimbursing this new non-invasive
reimbursing this new non-invasive prenatal test that was recently
prenatal test that was recently
prenatal test that was recently developed so you see even in high-income
developed so you see even in high-income
developed so you see even in high-income countries
countries
countries changing and thinking about the way we
changing and thinking about the way we
changing and thinking about the way we finance healthcare to get doctors to
finance healthcare to get doctors to
finance healthcare to get doctors to provide appropriate care is an ongoing
provide appropriate care is an ongoing
provide appropriate care is an ongoing process that will never really be
process that will never really be
process that will never really be finished but it’s crucial it’s crucial
finished but it’s crucial it’s crucial
finished but it’s crucial it’s crucial if we’re serious about getting these
if we’re serious about getting these
if we’re serious about getting these systems to deliver interventions to
systems to deliver interventions to
systems to deliver interventions to those who need them while keeping them
those who need them while keeping them
those who need them while keeping them on a budget and this is a challenge that
on a budget and this is a challenge that
on a budget and this is a challenge that especially many developing countries
especially many developing countries
especially many developing countries will be struggling with in the next few
will be struggling with in the next few
will be struggling with in the next few years the United Nations they have
years the United Nations they have
years the United Nations they have called for universal access to basic
called for universal access to basic
called for universal access to basic health care by 2030 and this is great
health care by 2030 and this is great
health care by 2030 and this is great it’s about time that nowhere in this
it’s about time that nowhere in this
it’s about time that nowhere in this world women die from giving birth or
world women die from giving birth or
world women die from giving birth or children die from simple diarrhea but we
children die from simple diarrhea but we
children die from simple diarrhea but we have to remember we don’t need new drugs
have to remember we don’t need new drugs
have to remember we don’t need new drugs or vaccines for that we need to first
or vaccines for that we need to first
or vaccines for that we need to first cure the systems that deliver them thank
cure the systems that deliver them thank
cure the systems that deliver them thank you
”
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