title: Priority-setting institutions in health: recommendations from a center for global development working group.
abstract: The rationing problem is common to all health systems-the challenge of managing finite resources to address unlimited demand for services. In most low- and middle-income countries, rationing occurs as an ad hoc, haphazard series of nontransparent choices that reflect the competing interests of governments, donors, and other stakeholders. Yet in a growing number of countries, more explicit processes, with strengths and limitations, are under development that merit better support. Against this background, the purpose of the Center for Global Development Working Group, which is to examine how priorities are set currently, and to propose institutional arrangements that promote country ownership and improve health outcomes by more systematically managing this complex process of politics and economics, is discussed. Current global and national priority-setting practices in low- and middle-income countries, the potential for strengthened national institutions, and increased global support are reviewed. Recommendations for action are provided.
authors.affiliation: Center for Global Development, Washington, DC, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Glassman
authors.affiliation: National Institute for Health and Clinical Excellence, London, United Kingdom.
authors.forename: Kalipso
authors.initials: K
authors.lastname: Chalkidou
authors.affiliation: Independent, Bogota, Colombia.
authors.forename: Ursula
authors.initials: U
authors.lastname: Giedion
authors.affiliation: Health Intervention and Technology Assessment Program, Department of Health Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Yot
authors.initials: Y
authors.lastname: Teerawattananon
authors.affiliation: Center for Medical Technology Policy, Baltimore, MD, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Tunis
authors.affiliation: Department of International Health, Georgetown University, Washington, DC, USA.
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Bump
authors.affiliation: Health Technology Assessment and Economic Evaluations, Institute for Clinical Effectiveness and Health Policy, University of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Andres
authors.initials: A
authors.lastname: Pichon-Riviere