Global alliance on healthcare technology

The Global Alliance on Healthcare Technology is a new initiative of WHO and the World Bank to propose concrete solutions to the major problems facing developing countries regarding health technology. The first meeting took place in May 2003 in Washington, D.C, attended by representatives of international agencies, countries, industry, NGOs and experts in the management of health technology. The second meeting of the Global Alliance will be hosted by WHO in 2005.

At its first meeting, four working groups were established that covered (1) medical device regulations; (2) health technology assessment and development of appropriate technology; (3) acquisition and operations; and (4) education and capacity building for health technology management. Several issue papers were commissioned that served as background documentation for the discussions.

WHO opened the forum highlighting the particular challenges facing developing countries in managing health technology. The World Bank noted that the impact of it’s US$1.5 billion investment in medical equipment between 1997 and 2001 had not been satisfactory. Nearly a third of sophisticated equipment remained unused, while over a quarter had a downtime of over 25% due to weak capacity for maintenance.

Developing countries underscored the widespread lack of systems and capacity in this area, and called for coordinated international initiatives to deal with the rapid innovation and diffusion of medical technology throughout the world.

The Forum concluded that medical devices must be regarded from a life span perspective, from design to disposal. Proper management of each element is essential for optimal health service delivery. This raises the critical need to budget not only for capital investment, but for recurrent and replacement costs. Other recommendations were that:

• International agencies should help developing countries to strengthen their regulatory programmes;
• Developing countries should access the information available among HTA agencies;
• Health Technology Assessment should be an integral part of the medical device life cycle;
• Countries should establish national health policy, clinical/treatment guidelines so that proper needs assessments can be conducted before acquisition;
• Industry could assist by providing manuals and training;
• World Bank should explore financing of other modes of acquisition (e.g. turnkey, consumables, leasing, “up-front warranty” (e.g. 3 years), other recurrent costs).