Department of Health Systems Governance and Financing, World Health Organization
In 1986, I took an undergraduate degree in the liberal arts (mathematics major, philosophy minor) from St. John’s College in Annapolis, Maryland, and then worked for 2 years in the admissions office there before enrolling in 1988 at the University of Wisconsin at Madison to study Economics and Agricultural Economics, graduating in 1991 with an MSc in Economics and an MA in Agricultural and Applied Economics.
However, in 1992, I had an opportunity to work as a Researcher at the Johns Hopkins School of Medicine in the Department of Neurosurgery, which I did for a number of years and co-authored several papers for neurosurgical journals.
In 1994, I was offered a position as a technical editor in the Office of Publications at the World Health Organization (WHO), and I worked there in that capacity until 1998. At that time, though, WHO began to put more emphasis on economic analysis, and in 1999 I formally transferred into the newly formed Global Programme on Evidence and Information for Policy.
In that role I was part of the team that developed methods for the estimation of health system performance for the World Health Report 2000: Health Systems, Improving Performance, but in 2001 I began focusing more on the economic evaluation of interventions against risk factors using WHO-CHOICE methods of cost-effectiveness analysis (World Health Report 2002: Reducing Risks, Promoting Healthy Life). Concurrently I started work on a Ph.D. in Public Health at Erasmus University Rotterdam while also working full-time at WHO.
Since 2003 I’ve mainly worked on the use and interpretation of mathematical population models in cost-effectiveness analysis. In line with that work, I’ve contributed to the production of an evidence base (about 40 peer reviewed papers with over 2900 citations) on the economic evaluation of interventions for cardiovascular risk factors and disease, respiratory conditions, cancers, maternal and child health, HIV/AIDS, tuberculosis and chronic disease prevention. I’ve also led inter-disciplinary teams in a number of countries, in Latin America and Africa, on adapting the results of cost-effectiveness analysis to their national settings.
Currently at WHO-CHOICE I and close colleagues are leading a project to update the estimates of effects and costs for our entire knowledge base of about 500 interventions covering 22 distinct areas of disease, injury and risk factors. In the coming years we’ll be looking at how to make our technical assistance to countries more strategic and effective, in line with the WHO’s new focus on Universal Health Coverage.