Helping poorer countries make locally informed health decisions

With more money available for health in poorer countries, as well as increasing demand for services and new products, policy makers are looking for ways to expand access, reduce out of pocket spending, and improve outcomes without bankrupting national budgets. Decisions are still largely driven by historical norms, the priorities of foreign donors, and lobbying pressures, and it is uncommon for countries to have functional mechanisms for making decisions based on their own needs. However, demand is growing from foreign governments and funding agencies to give countries technical and strategic support to develop the capability to make decisions based on local evidence and values. The National Institute for Health and Clinical Excellence (NICE) has been working in partnership with national governments to strengthen local decision making. We use this experience to suggest ways in which decision makers can be empowered locally.