Abstract
Global health has undergone two revolutions in recent years. The first is a metrics revolution. Measurement of country progress in health and health systems is now a serious international concern. The person who launched this revolution was Gro Harlem Brundtland, WHO's Director-General from 1998 to 2003. She established a unique cluster of expertise within WHO called “Evidence and Information for Policy”. In her biography, Madam Prime Minister (2002), she emphasises the importance she placed on developing the methods, tools, and standards to generate reliable knowledge for health decision making. It was under Brundtland that WHO revised its vision to be “a focal point for the best research”. She invested the agency's resources in “what we called the evidence base, the data for health policy analysis”. Her goal was to “further develop the technical excellence of WHO”. “We must push for better data”, she wrote. Brundtland's successors have pursued their own visions for global health, but none has placed such a high priority on measurement and research. As WHO has stepped back from investing in metrics, so others have assumed leadership. The Bill & Melinda Gates Foundation, with over US$3 billion in annual grant spending, has taken over as the global standard bearer for research and better data. As two recent reports on MDGs 4 and 5 from the Gates-funded Institute for Health Metrics and Evaluation have shown, the scientific community has much improved the methods for monitoring changes in mortality—methods that have enabled far more precise prioritisation of actions in countries.
Published Version
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