A Harvard program to improve health care delivery around the world is increasing its focus on the leaders and decision-makers who ensure that local health clinics are properly supplied and fully staffed.Nine finance ministers from developing nations spent four days at Harvard’s Loeb House to discuss the importance of health to a nation’s economic performance and how to design health care systems that are both efficient and effective.Michael Sinclair, executive director of the Ministerial Leadership in Health Program, said there is often internal tension between health and finance leaders because their aims are at odds — at least on the surface. While health ministers are concerned with implementing programs that reduce disease and save lives, finance ministers want to ensure scarce government funds go where they’re most needed and are often beset by competing priorities from different government agencies.The program Sinclair leads helps finance ministers understand the common ground they share with health ministers: ensuring health programs are well designed, well executed, and provide the biggest health boost for the buck. Waste reduction is particularly important, he said, because some estimates say as much as 40 percent of health spending is squandered each year through corruption, theft, and inefficiency.It can be difficult to predict a health system’s burdens from year to year, Sinclair said, because natural disasters and disease outbreaks can upset even the most carefully designed plans.“The budget drives everything in health. It does in all other sectors, but most particularly in health,” Sinclair said. “We’re trying to align the two.”The Ministerial Leadership in Health Program, sponsored jointly by the Harvard T.H. Chan School of Public Health and the Harvard Kennedy School, is conducted in a workshop setting that draws on the personal knowledge and experience of participants. This month’s gathering was attended by finance ministers from Sri Lanka, Mozambique, Burkina Faso, Guinea-Bissau, Bhutan, Ethiopia, Gabon, Guyana, and the Bahamas. A similar event for health ministers is scheduled for June.Ministers were paired with experienced partners — many were former ministers themselves — who facilitated goal-setting and the initial drafting of possible programs to reach those goals. Ministers heard case studies of successful programs in Turkey and Malaysia, as well as the potential effects of specific initiatives, such as universal health coverage, tobacco control, and public-private partnerships.The event included sessions on leadership — learning from mistakes, priority setting, and budgeting. Rifat Atun, a professor of global health systems at the Harvard Chan School and faculty chair of the program, said that it emphasizes links between economic growth, poverty reduction, and health. One of the program’s strengths, he said, is that it allows ministers to step back from the often frantic day-to-day business of government to get a larger perspective.“There’s a very good sharing of experience, sharing of perspective,” Atun said. “They’re thinking about action, which is very useful.”Rosine Coulibaly, Burkina Faso’s minister of economy, finance, and development, has been on the job for only three months. She said the sessions helped her understand the particulars of the health sector and highlighted possible policy tools.“I think it is very, very useful,” Coulibaly said.With the Bahamas about to embark on an ambitious health-care expansion, Michael Halkitis, its minister of state for finance, was hoping for insights from his counterparts that might smooth the process.“It’s been very helpful … to hear the experiences of ministers from other parts of the world,” Halkitis said. “What you learn is that a lot of the problems are common. The bottom line is we’re basically all in the same boat.”
Following the Wisconsin football team’s 35-6 Homecoming victory over Northwestern, head coach Gary Andersen reflected on Tanner McEvoy’s development and the dominating defense as the Badgers (4-2, 2-1 Big Ten) enter the second half of their schedule.While UW’s three-pronged rushing attack of Melvin Gordon, James White and freshman newcomer Corey Clement usually earns most of the praise, Andersen rightfully highlighted the stout effort his defense put forth Saturday, holding Northwestern without a touchdown — a first for the Wildcats in seven seasons.“This defense has had great effort all year long, but there were some extra effort plays in that game that just jump out at you,” Andersen said.Among Saturday’s “unusual efforts” Andersen mentioned were the seven sacks made by seven different Badgers, a statistic that exemplifies how the defense has excelled by utilizing its depth in Andersen’s scheme.“I think they’re adjusting to the amount of packages and really understanding that there are not 11 starters on this defense, there’s up to really 15 or 16 starters, if you will,” Andersen said.Expectations seem to be rising throughout the defense, which allowed Andersen to shine light on one player that may be new to defense, but not to high expectations.A highly-touted junior college transfer, McEvoy joined the Wisconsin program this summer with many drooling over the prospect of a 6-6 dual-threat quarterback commanding Andersen’s offense. However, after breaking his hand during preseason preparations, McEvoy’s potential offensive contribution seemed unlikely, so the coaching staff tried him out on defense.Despite his initial reputation as a quarterback, McEvoy seems to embrace physical play and his all-around athleticism has earned him increasing playing time at safety. He has registered eight tackles in UW’s last two games.“He’s a smart kid, that’s not an easy position to play. Mentally, to go over there and grasp it as quickly as he has and be able to get into a game like Northwestern, with all that offense, to be able to deal with it is a true credit to the kid,” Andersen said.Fortunately for McEvoy and the Badgers, their experience defending Northwestern should come in handy this Saturday, when they face another mobile quarterback in Illinois’ Nathan Scheelhaase.Although the Illini have not won a conference game since October of 2011, Andersen insisted his team is well aware of the dangers they’ll face in Champaign.“We talk all the time about respecting our opponents,” Andersen said. “In the morning meeting with the coaches, the kids seemed to be focused and moved in the right direction.”Andersen also discussed some of the formations his offense showed last Saturday and his intention to prepare more options moving forward.“The playbook is ever-growing. It is year one, you still got to have a foundation and a base offense before you continue to build on that, but I know they build on it every single week,” Anderson said.One look Badger fans could see more of down the road is the Wildcat formation, which eliminates the quarterback in favor of two running backs in the backfield. UW attempted the Wildcat sparingly last Saturday, but their execution requires more practice, according to Andersen.“We’ll have to hone in on that a little bit more, but I think that will be something that will definitely help us as we move forward to get a little pace out of the offense,” Andersen said.An additional aspect that could help the offense get going this Saturday is the return of leading wide receiver Jared Abbrederis.After opening UW’s scoring with a 63-yard touchdown catch, Abbrederis exited Saturday’s contest during the second quarter due to a head injury. While he did not re-enter the game, coach Andersen is optimistic about Abbrederis’ prospects of playing this weekend.“I am hopeful and I feel good about that, but we’ll know more in the next 48 hours. If Jared has the opportunity, he’ll go,” Andersen said.