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
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
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
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
- 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):
- 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.
- 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;
- 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
- 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.