INVESTING IN HEALTH WISELY - THE ROLE OF NEEDS BASED TECHNOLOGY-ASSESSMENT

Countries worldwide spend huge sums on health-about $1,700 billion a y ear, or roughly 8% of global income. But the World Development Report 1993: Investing in Health shows that these monies could be spent much more wisely, in the process doing a great deal to help the world's 1 b illion poor. Essential national public health and clinical packages ar e proposed based on assessment of the burden of disease (measured in d isability adjusted life years) and the cost-effectiveness of intervent ions. Governments can play a central role in improving the health of t heir citizens: they can foster an environment that enables households to improve health and they can also improve their own spending on heal th, targeting it to support universal access to essential national pub lic health and clinical packages based on the above methods. This is a good example of the concept of needs-based technology assessment, com bining the disciplines of epidemiology, economics, and policy formulat ion. When applied, it should lead to improved effectiveness, efficienc y, and equity.