In the near decade since Bloomberg Philanthropies launched its 2015 Data for Health Initiative, it has invested hundreds of millions of dollars to help governments in 31 countries track a few basic pieces of information: births and deaths. Why is that so important? It turns out that about half of all deaths globally go unreported, particularly in low- and middle-income countries, including the causes of those deaths. But that basic information can help governments make policy with the greatest potential to impact public health.
The Data for Health Initiative follows Bloomberg’s broader strategy to help communities and countries use objective data to inform responses to public health issues — particularly for noncommunicable diseases and non-disease challenges. These include cardiovascular diseases, tobacco use, diet and obesity, drug overdose deaths, road safety and more. Recently, Bloomberg announced it was committing another $150 million to the initiative, bolstered with an additional $40 million from the Bill and Melinda Gates Foundation, which has contributed to the program both financially and with expertise for about five years. In total, Bloomberg and partners have committed $436 million to the initiative.
Data for Health has assisted in the collection of 12.2 million birth records and 16.2 million death records in 31 countries — primarily low- and middle-income nations — that have historically lacked the practices, organizations or technology to collect this information. I spoke recently with Dr. Kelly Henning, a physician who leads the public health program at Bloomberg Philanthropies, about Bloomberg’s sharp focus on this type of data — and why it can be so difficult to track and collect in some parts of the world.
Improving the information pathway
“Each country really needs to have their own data to understand the demographics as well as to develop prevention and intervention strategies,” Henning told me. There are a couple of reasons, she explained, that countries don’t routinely collect birth and death data, much less analyze it. “In many countries, the majority of deaths occur outside of the health system, so they’re not happening in a hospital or an emergency room — they’re happening at home or in some other location.”
And in some countries, she said, local organizations may be collecting birth and death data, but not sharing it with the government departments or ministries of health that are in a position to analyze that data for national policymaking purposes. As might be expected, the bottlenecks are sometimes technological — a shortage of computer systems, for example. But beyond any one specific barrier or bottleneck, Henning said, the Bloomberg team aims to help organizations in these countries develop and implement systems for collecting information and sharing it. “It’s really more about helping countries think through the pathway of the information,” she said. “Where does it go, who sees it, who touches it? How does it get from A to B in a timely manner, et cetera.”
Through the Data for Health Initiative, Bloomberg says it has trained more than 120,000 individuals, in nonprofits and other local organizations across the 31 countries, to carry out the collection of birth and death data, as well as to analyze and use the data to advance policy.
In Mumbai, India, for example, the program helped city officials create teams to improve coding of causes of death, reducing instances of unusable cause-of-death data from 26% to just 2%, which enabled city health officials to increase screening for hypertension and diabetes. In Rwanda, the Bloomberg initiative helped to more than quadruple the number of death records by integrating health and civil registration authorities. In Shanghai, China, Bloomberg worked with government officials to more accurately understand the number of people in that city who died from smoking-related illnesses, helping make the case for policies to reduce smoking.
The initiative also worked with authorities in Colombia to improve data collection systems. Then, when COVID-19 broke out, health officials there were able to pivot quickly from the analysis of noncommunicable disease to track COVID-related death data and develop action plans for the pandemic. “It was a very quick transition, and a proof of concept that this data for health work is broadly useful to countries when they’re faced with not just noncommunicable diseases, which are so important, but acute health issues, as well,” Henning said.
“They can act on it locally”
The Data for Health Initiative’s newest areas of focus — which will be targeted through this latest phase of investment — are vulnerable populations such as refugees and stateless people. Bangladesh and Indonesia, both of which have large refugee populations, are among the first countries where the initiative will aim to improve data collection.
Birth and death data may not be as exciting as cutting-edge therapeutics and cures, but they can help governments address and prevent some of the world’s biggest health threats, such as cardiovascular disease — the leading cause of death worldwide — or diseases like lung cancer that are linked to smoking.
Considering Bloomberg’s commitments through Data for Health and its numerous other targeted, high-dollar efforts to move the needle on pervasive public health problems, we have to give this funder high marks for effectively deploying a data-driven approach and “big bets” giving to take on what ails people. And now that Mike Bloomberg, 82, intends for the remainder of his stupendous fortune to further beef up Bloomberg Philanthropies, there’s a lot more where that came from.
At the same time, we’ve also been critical of what Bloomberg and other grantmakers may be glossing over when they put all of their chips into wonky, data-centric approaches. In the end, whether it’s in the U.S. or abroad, local factors — like ideology-driven politics — make it difficult for philanthropy to simply dive in and solve public health problems whole cloth. But funders like Bloomberg can provide tools and expertise that governments and local organizations can choose to make use of, or not.
“We really focus on data-driven decision-making and helping countries think about how they can use their own data,” Henning said. “There are global systems around the world, academic systems to estimate deaths and births, but that doesn’t help the individual country. They need their own data such that they can act on it locally.”
