During the PMAC 2015, a side meeting on the role of the international Decision Support Initiative (http://www.idsihealth.org/about-us/) was organized in order to discuss: progress of the initiative so far and the challenges of country-led reforms. To begin, NICE International gave a presentation on HTA as a means of setting priorities for Universal Coverage. This presentation discussed the importance of health technology assessments (HTA) in priority setting for benefit packages and the role of the iDSI internationally. Open discussions revolved around three main themes: priority setting, iDSI’s challenges, and HTA.
Two main discussion points were raised for priority setting. The first is the inclusion of different tools and/or components to be considered in priority setting, such as healthcare resource management and capitation. One example of this is procurement and moving money throughout different geographical locations or health system levels. The second discussion point was the measure of success in priority setting, as there may be issues with variations in defining demand, balancing the fine line between working on international collaborations and addressing domestic needs, and understanding the proper factors (e.g. gauging stakeholder commitment) and timing to act.
In terms of iDSI and the challenges of international donors, points were raised about the current situation of iDSI, previous donors, and the model being used in supporting low- and middle-income countries. iDSI’s main challenges are sustainability at the country and global levels, a flexible and extensive network that may need a more focused approach or process, and the need to develop a unique identity that will cover the broad range of its products. This is coupled with problems such as set timelines (e.g. 2-3 years) that imply a possible lack of project sustainability and that their models and researches must be used critically in low- and middle-income countries (even though the principles and models that were used in high-income countries may be transferable).
However, despite the more elevated relevance of the first two themes, most of the discussions revolved around HTA, in particular that HTA will build national guidelines (e.g. for clinical pathways) and how this connects to the global effort, inclusion of behavioral change in HTA, dealing with country-specific healthcare system factors, the conducive factors of HTA and its importance in priority setting, and the capacity building necessary for HTA work.
