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Energy: Centre on Global Change and Health
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Designed by Adrian Cousins
Maintained by Centre co-ordinator

London School of Hygiene & Tropical Medicine
Finance, trade and macroeconomics

Globalization is one of the key challenges facing health policy makers in the twenty-first century. The application of the discipline of economics to this issue is undertaken through three streams.

First, that of international finance.

The landscape of healthcare financing is changing. All countries are grappling with resource allocation and prioritisation issues domestically, but this is made increasingly complex by the context of changes to global health finance.

Changes in aid policies, the reduction in influence of national government, the rise of NGO°s, global public-private partnerships and individual philanthropists, together with the development of new finance mechanisms, such as advance-purchase agreements, has complicated domestic policy making and traditional economic governance.

Work under this stream therefore seeks to apply the concepts, methods and evidence from political-economics to the study of international health finance.

Second, that of international trade.

Most countries are undertaking trade reforms to increase the openness of their economy to trade generally ¬ reducing tariffs, quotas and regulatory barriers for instance ¬ and the health-sector specifically. This will impact both upon health and the health sector.

Third, that of applying the concepts and methods of macroeconomics to the study of health and health-related issues.

Health economics has a strong history in micro-economic analysis, but far less in macro-economic analysis. In particular the development and application of macro-economic models to the study of health issues to asses the linkages between health and other sectors of the economy, and the domestic health sector and other countries.

Work in this stream thus concentrates on building and using such models to consider a range of health issues, including those in the other two streams mentioned above, but also in the areas of infectious disease and environmental change.

  • Development and application of macro-economic models to infectious disease through three EU FP6 funded projects: SARS Control, GRACE and CHAMP.
  • Work on the macro economics and trade aspects of genomics, in collaboration with the UEA Global Biopolitics Research Group.
  • Work on trade encompassing: (i) the development of an index to measure openness of health sector to trade; (ii) application of a framework for country analysis of trade impact on health; and (iii) development of a variety of training and teaching materials. Most of these are in collaboration with the WHO Globalization, trade and health° team.
  • Work in international finance, including: (i) revisions to the book Global Public Goods for Health° for a second edition; and (ii) the economics of global health governance.

  • Smith RD (2004) Foreign direct investment and trade in health services: a review of the literature. Social Science and Medicine; 59: 2313-2323.
  • Smith RD, Woodward D, Acharya A, Beaglehole R, Drager N (2004) Communicable Disease Control: a Global Public Good° perspective. Health Policy and Planning; 19(5): 271-278.
  • Smith RD, Thorsteinsd ‹ttir H, Daar A, Gold R, Singer P (2004) Genomics knowledge and equity: a global public good°s perspective of the patent system. Bulletin of the World Health Organization; 82(5): 385-389.
  • Smith RD, Yago M, Millar M, Coast J (2005) Assessing the macroeconomic impact of a healthcare problem: the application of computable general equilibrium analysis to antimicrobial resistance. Journal of Health Economics; 24: 1055-1075.
  • Smith RD, Yago M, Millar M, Coast J (2006) A macro-economic approach to evaluating policies to contain antimicrobial resistance: a case study of methicillin-resistant staphylococcus aureus (MRSA). Applied Health Economics and Health Policy; 5: 55-65.
  • Blouin C, Drager N, Smith RD (eds) (2005). International Trade in Health Services and the GATS: Current Issues and Debates. World Bank.
  • Smith RD (2006) Trade in Health Services: Current Challenges and Future Prospects of Globalisation. In: Jones AM (ed). Elgar Companion to Health Economics. Edward Elgar: chapter 16.
  • Smith RD (2006) Responding to global infectious disease outbreaks: lessons from SARS on the role of risk perception, communication and management. Social Science and Medicine; 63: 3113-3123.
  • Smith RD (2006) Trade and public health: facing the challenges of globalization. Journal of Epidemiology and Community Health; 60: 650-651 (invited editorial).
  • Smith RD (2006) Measuring the globalisation of health services: a possible index of openness of country health sectors to trade. Health Economics, Policy and Law; 1: 323-342.
  • Smith RD, Blouin C, Drager N, Fidler DP (in press) Trade in health services and the GATS. In: Mattoo A, Stern RM, Zanini G (eds). A handbook of international trade in services. Oxford University Press.
  • Smith RD, Drager N, Hardimann M (eds) (in press) The rapid assessment of the economic impact of public health emergencies of international concern. Oxford University Press.
  • Smith RD, MacKellar L (2007) Global Public Goods and Health Agenda: Problems, Priorities and Potential. Global Health; 3:9.
  • Sadique MZ, Edmunds WJ, Smith RD, Meerding WJ, de Zwart O, Brug J, Beutels P (2007) Precautionary behaviour in response to the perceived threat of pandemic influenza. Emerging Infectious Disease; 13(9): 1307-1313.
  • Beutels P, Edmunds WJ, Smith RD (2008) Partially wrong? Partial equilibrium and the economic analysis of public health emergencies of international concern. Health Economics; 17(11): 1317-22.