Publications

    Madore A, Rosenberg J, Weintraub R. “Sin Taxes” and Health Financing in the Philippines. Harvard Business Publishing. 2015.Abstract

    This case traces the implementation of tobacco tax policy and health system reforms in the Philippines from 2009 to 2015 in the context of the global tobacco control movement, the economic and political influence of the Philippine tobacco industry, and the Philippine health system. After providing background on the prevalence and costs of smoking in the Philippines, the case follows the steps taken by a diverse group of actors to design, promote, and implement higher taxes on tobacco and alcohol products, the primary goals of which were to reduce smoking and raise funds to achieve universal health care. The case highlights the strategies used to counter opposition from the tobacco industry and allied politicians. It focuses on Health Secretary Enrique Ona’s efforts to support sin tax reform and how the country used the resulting revenues to try to improve health care and health insurance coverage. It ends with Ona contemplating the impact of his investments in national health insurance and public health infrastructure as a new health secretary takes his place.

    Teaching Note available through Harvard Business Publishing.

    From left to right: House of Representatives; Woman selling cigarettes
    From left to right: House of Representatives; Woman selling cigarettes. Source: Global Health Delivery Project case writers.

    Learning Objectives: A productive class discussion will allow students to appreciate the complexity and trade-offs governments may face in stimulating their economy, regulating industry, and improving public health; the importance of data in driving and sustaining policy reform; the role of financing policies and funding as tools for health system strengthening and value creation when leveraged strategically; and the potential for health to unify different actors and sectors to generate new policy and restructure fiscal and financial systems.

    Keywords: Health insurance, health care financing, tobacco control, smoking, universal health care implementation, policy, cross sector collaboration, health system reform, political leadership, management

    Wachter K, Talbot JR, Weintraub R. Partners In Health in Neno District, Malawi. Harvard Business Publishing. 2013.Abstract

    Set in Neno District, Malawi from 2007–2012, the case focuses on the economic impact of investing in health care infrastructure. It examines management decisions that leaders of Abwenzi Pa Za Umoyo (APZU) and its founding organization—Partners In Health (PIH)—made as they supported the Government of Malawi in building a hospital and scaling up the delivery of APZU clinical and social programs across Neno district. The case highlights how a non-governmental organization can navigate the politics and local culture to improve Malawi’s health care system in close partnership with a strong, protocol-driven government. The case begins with Ophelia Dahl, co-founder and executive director of Partners In Health, reflecting on her December 2011 trip to Neno, nearly four years after her first visit. She observed signs of progress unrelated to health—bank branches had opened in town, a new road had been built, and the market had expanded dramatically. Ultimately, the case explores what this demonstrates about the value of her organization’s investments in health.

    Teaching Note available through Harvard Business Publishing.

    Neno rural hospital
    In the foreground: One-story original structures of Neno Rural Hospital used for outpatient and maternity services. In back: Two-story building constructed by APZU and partners used for inpatient wards, meetings, computer use, laboratory work, and government offices. Source: Keri Wachter, 2012.

    Learning Objectives: To understand the challenges of hiring and retaining local and expat staff, the complexity of an international NGO partnering with the government to improve health care, how leadership acumen and approaches impact scaling up and sustaining health care delivery, the relationship between the district hospital and the local economy, and how to assess impact beyond health measures.

    Keywords: Global health, social equality, project management, business and government relations, partnerships, strategy, economic development, health care policy, health care delivery, public health, human resource management, developing countries, innovation

    Talbot JR, Cole C, May M, Weintraub R. Voluntary Medical Male Circumcision in Nyanza Province, Kenya. Harvard Business Publishing. 2012.Abstract

    This case traces the development of the voluntary medical male circumcision (VMMC) campaign in Nyanza Province, Kenya as it transformed from the subject of a randomized clinical trial into national policy. After providing some background on the cultural, political, and scientific context surrounding male circumcision, the case traces the PEPFAR-funded implementers' advances in delivering male circumcision in Nyanza. It examines the various delivery models used in Nyanza and the evolution of the relationship between implementers as well as on the development of the national strategic plan for VMMC released in 2009. The case ends with the implementers having come together successfully for two rapid, aggressive, 30-day implementation campaigns and the head of Kenya's National AIDS and Sexually Transmitted Infections Control Programme wrestling with how to make such campaigns sustainable and what lessons from the campaign to pass on to the national program.

    Teaching Note available through Harvard Business Publishing.

    Mobile Service Delivery Model
    (A) Group counseling on male circumcision; (B) mobile circumcision counseling site; and (C) circumcision being conducted in tented delivery site. Source: Nyanza Reproductive Health Society.

    Learning Objectives: To understand how a randomized controlled trial may be translated into a large-scale public health program; how a surgical campaign was designed and implemented for rapid impact; the role of national and international collaboration in large-scale health delivery; and the ethical tradeoffs that arise in large-scale public health programs.

    Supporting Content: There is a shorter version of this case titled Voluntary Medical Male Circumcision in Nyanza Province, Kenya (Condensed Version).

    Keywords: Project management, AIDS, policy, supply and demand, partnerships, strategy, innovation