BUILDING THE

FUTURE’S HEALTH LEADERS

20 YEARS OF HEALTH POLICY,
PLANNING AND FINANCING
This publication is a journey across 20 years of the history of Health
Policy, Planning and Financing (HPPF), of LSE and LSHTM. Through
the biographies of some HPPF alumni, the memories of some of the
faculty and staff who have been running the programme, and many
other bits of history, we hope to be able to show the breadth of the
success of this unique programme and the hard work behind it. We
shall not pretend to give the full picture. Many outstanding students
and their achievements, as well as many faculty and staff, will not
find a space here, but we hope they will do in the next edition in 20
years time (or maybe sooner…). We want to thank, among many
others, Anne Mills, Kim Jones (HPPF ’06), Yoko Laurence (HPPF ’06),
Errol Lobo, and Anthea O’Sullivan for their invaluable help in realising
this publication.
Franco Sassi, LSE Department of Social Policy, and Dirk Mueller,
LSHTM Department of Public Health and Policy

1987-88
1988-89
1989-90
1990-91
1995-96
 Celebrating 20 years of success…
LSE and the London School of Hygiene & Tropical Some of the HPPF graduates have continued, or
Medicine have offered this year for the 20th moved on to, a career as a health professional. For
consecutive time their joint graduate programme them too HPPF has made a difference, opening up
in Health Policy, Planning and Financing. This new perspectives in the practice of medicine and
Masters of Science was created in 1986 under other health professions.
the leadership of LSE’s late Professor Brian Abel-
The MSc HPPF has for twenty years been at
Smith and has since established itself as one of
the forefront of postgraduate health policy
the leading health policy programmes worldwide.
Howard Davies programmes and I hope that this publication will
It is one of the earliest examples of institutional
Director, LSE prove a fitting tribute to the work carried out by
collaboration for the two University of London
the teachers and students on the MSc programme
Colleges, and one that has been successful
over these years. Equally, I hope that the events
throughout. The programme has attracted large
that will celebrate the 20th Anniversary of HPPF
numbers of students since its early years, from
will enable staff, students and alumni to renew old
all continents. This booklet shows the breadth
friendships and build some new ones. On behalf of
and the importance of the many achievements
LSE I would like to extend a warm welcome to all
by the almost one thousand graduates from the
those who will join the newly established Health
programme. In many countries and international
Alumni Network, which hopefully will improve
organizations, HPPF Alumni have become
communication and collaboration in the future.
leaders in the field of health policy. They have
made a difference in academic research, in the
management of health care organizations, in the
development and implementation of policy.

…and looking forward to the next 20 years

The MSc in Health Policy, Planning, and Financing outstanding teaching skills and breadth of the
has an internationally recognised track record in experience which has resulted in sustained success.
training leading health policymakers from a wide
The course has also attracted outstanding students,
range of countries. It was launched following many
many who have gone on to prominent careers in
months of planning by Brian Abel-Smith and John
a range of institutions including, universities and
Carrier from the London School of Economics and
research institutions, governments, international
Political Science and Jenny Roberts and Anne Mills
agencies or NGOs. It has succeeded in equipping its
from the London School of Hygiene & Tropical
Andy Haines graduates not only with the methodological tools
Medicine. Originally the title was restricted to
Director, LSHTM to understand trends in health and disease and the
‘Planning and Financing’ and the word ‘Policy’ was
potential impacts of policies on health outcomes,
introduced into the title after Lucy Gilson took over
but also the tools to apply what they have learnt in
from Anne Mills as Course Director in 1992.
their day-to-day work.
The fruitful partnership between LSE and LSHTM
I would like to express my thanks to Franco Sassi
has endured for 20 years and is still in robust
and Anne Mills for their contributions to HPPF and
health. Uniquely it brings together complementary
for their roles in organising this publication. As well
expertise from the two institutions and gives
as looking back at the successes of the past, we
students access to an impressive and well-rounded
also look forward to the next 20 years of the course
range of disciplines relevant to the topic area. The
and the expectation that it will continue to provide
continued success and high profile of the HPPF
superb academic experience for future leaders in
MSc is a tribute not only to those far sighted
the field.
individuals who set it up two decades ago but also
to the outstanding staff from both institutions who
have taught on the course over the years. It is the
combination of multi-disciplinarity, academic rigour,

1
 Working together for the future of health care
Franco Sassi
HPPF is an exceptional programme.
From any perspective HPPF stands
out as an extraordinary asset
for the Schools that offer it and
an extraordinary opportunity
for the students who choose
to enrol in it. It is arguably the
longest established health policy
programme in the UK, and one
of the oldest worldwide. It is
taught by two colleges that have
been at the forefront of the social
sciences and public health for
many years. LSE and LSHTM have
engaged in a successful and long-
lasting partnership of a kind that
is not often seen in a competitive
academic world.
Hilary Goodman, at LSHTM, and
I took over from Lucy Gilson in
1995 as programme directors. It
was a daunting task. With very few
exceptions, students were older than
me and their experience in health
policy was impressive. It took a lot
more than Italian-style shoes and
initials embroidered on my shirts
to keep their interest alive and be
recognised as their course leader.
But the rewards have always been
far greater than the efforts, and I was
lucky enough to share this role with
excellent colleagues, Hilary first and
Paul Jacklin later, in particular.
From any I was asked to develop what used
to be the second half of the health
perspective HPPF
economics course. This changed
stands out as from a broad Economic analysis for
an extraordinary management, policy and evaluation
asset for the into a more narrowly focused course
Schools that on Cost-effectiveness analysis
in health care. I remember the
offer it and an
bewildered looks of some of the
extraordinary students when I first introduced a
opportunity for rather unfriendly software to help
the students who them build decision trees. We now
choose to enrol use more sophisticated instruments
but, most of all, none of the students
in it. It is arguably
is taken by surprise at the sight of
the longest a decision or cost-effectiveness
established health model because the concept
policy programme and the language have become
in the UK, and commonplace in health policy
making in so many countries.
one of the oldest
worldwide.
2
The curriculum of studies has been
adapted to the changing needs
of students and employers in the
health sector. A review of the
programme that led to the change
of its name, overseen by Lucy Gilson
in 1992-93, was followed by two
further reviews in more recent
years. The range of courses offered
to students kept expanding and so
did their contents. Choice increased
constantly as the two Schools got
more and more involved in the
teaching of health policy and related
subjects and moved to a modular
teaching structure. The LSHTM
Department of Public Health and
Policy was the first to develop a new
programme on its own in the early
1990s, the MSc in Health Services
Management, now subsumed as a
stream under the new Public Health
programme. The LSE Department
of Social Policy launched an MSc
in International Health Policy in the
mid-1990s, to which a specialist
Health Economics stream was added
more recently, as well as a MSc in
Health, Population and Society. For
every new programme introduced by
either School, new options became
available to HPPF students. What
continues to amaze me is how HPPF
was always strengthened, rather
than weakened, by the introduction
of new programmes at the two
Schools. Numbers of applicants and
students on the course never went
down because of this, rather they
kept steadily on an increasing trend.
The students on the programme have
been its most valuable asset. Almost
every year we have participants
from all continents who bring to the
programme invaluable experiences
and a strong commitment to
improve health policy throughout
the world. The average student age
has decreased, mainly because of
a growing number of bright young
students from North America,
many of whom taking a break in
their medical studies. We have
increasing numbers of applicants
from European countries, including
Eastern Europe, and from Asia. As a
result, the ‘development’ component
of the programme has progressively
broadened its focus to what is now
a global health perspective. Being
part of the HPPF class has always
been listed as the best aspect of
the MSc in all end-of-year student
evaluations during my time as
programme director.
Both LSE and LSHTM have invested
heavily in health policy research since
the establishment of HPPF. LSHTM
developed such initiatives as the
Health Economics and Financing
Programme, in 1990, and more
recently ECOHOST, a research centre
on health and health care in Eastern
Europe and the former Soviet Union,
and the Consortium for Research
on Equitable Health Systems. LSE
launched the research centre LSE
Health in the early 1990s, also thanks
to the efforts of Brian Abel-Smith,
which merged in the year 2000 with
the Personal and Social Services
Research Unit to become LSE Health
and Social Care.
After responding so well to so
many challenges over the last
twenty years, the programme now
faces new challenges. Health care
reforms have been designed and
implemented throughout the world,
in industrialised as well as developing
countries. A key challenge today is
providing rigorous evidence of the
impact of such reforms, enabling
all those involved in the making of
health policy to understand what
works and what does not and why.
An increasing emphasis is being
placed on the social determinants
of health, leading to a growing
recognition of the role of factors
outside health care as determinants
of health and disease. Health Policy
studies, accordingly, will have to
expand their focus well beyond the
boundaries of health care systems.
Interactions between health systems
and the rest of the economy, as
well as macroeconomic dynamics
impinging on the health sector, will
also become the focus of increasing
attention within health policy
studies. We are all ready for the
new challenges.
A painful but rewarding birth
Jenny Roberts
The birth of MSc Health Planning and Financing in
1986 was the result of a long and difficult gestation.
Beginning in early 1984 with an angry memo from
me, typed by Tricia Foley, to the Teaching Policy
Committee at LSHTM with a copy to Brian Abel-
Smith and the Social Science and Administration
Department at LSE. LSE and LSHTM had a long history
of collaboration in teaching (Jerry Morris, Richard
Titmuss, Brian Abel-Smith and others jointly teaching
in both institutions). An earlier suggestion of mine
for a joint degree had been met with a lukewarm
response. Now a new degree in Health Policy and
Planning had been submitted for approval to the
University by another college. The two institutions
with greatest expertise in the health were likely to
be sidelined.
This time I did get a reaction and indeed considerable
support from Brian Abel-Smith at LSE and Gordon
Smith and Patrick Hamilton at LSHTM. First we had to
explore the University requirements that had to be met
before a new degree would be sanctioned and then
proposals had to be presented to teaching committees
at each School so that the proposal could enter the
hierarchy of meetings that made up the administrative
process. Each meeting was a battle as the new degree
unexpectedly intruded on other people’s agendas
and territories. By November 1984 the proposal was
submitted to the University via the Board of Studies in
Social Administration and it subsequently proceeded
through the University committees. In the late spring of
1985 we got University approval. For me it had been a
painful birth!
Society, Basic Community Health, Health Planning
and financing and Health Economics. Tricia Foley who Jenny Roberts and
became course secretary at LSHTM did a magnificent Tricia Foley
job of supporting us all in those early years.
Another unexpected development at this time was
the establishment of the research degree programme,
MPhil/PhD Health Planning and Financing. This was
encouraged by Kenneth Warren who as a visitor
to LSHTM had seen the potential for developing
a programme based on HPF that would attract
‘outstanding people who are likely to occupy key
positions in the future health related sectors of their
countries’. Gordon Smith (then Dean of LSHTM at the
time) and myself worked, in his smoke filled room,
throughout Maundy Thursday – then a holiday – to
get the proposal into Rockefeller to meet a deadline.
We were successful in getting the funds from the
Rockefeller Foundation and University approval. This
was a great boost to the programme, it funded staff
and attracted some very talented students.
I enjoyed being associated with HPF (HPPF) programme in
those early years. I had the pleasure of working with some
wonderful colleagues and some very remarkable students.
We had fun: carnivals, trips to Italy; and established a
network of friends from all parts of the world.

It was rewarding, however, especially when we won

a University New Initiative Post to support the course.
This was advertised in December 1985 – Anne Mills
was appointed.

A formal Joint Policy Committee of those closely

involved with the programme – Brian Abel-Smith,
Patrick Hamilton, John Carrier, Anne Mills, and myself
(with others to advise on their subject areas) was set
up to refine the curriculum, produce bibliographies
and allocate responsibilities and handle the publicity.
Handbooks were prepared, timetables agreed and a
welcome letter sent out. We were ready.

The course began in October. We had 18 students who

named themselves the pioneers! Anne was pregnant
and after a short initial stint as co-ordinator had to take
leave. I took over with the stalwart support of John
Carrier at LSE. There was no modularisation in those
days and no charge for auditing courses so many of the
students attended more than the required courses and
turned up for both developed and developing country
seminars. Some explored courses in development
economics and public finance as well as our rich agenda
of courses in Social Dimensions of Health, Health and

3
 1986-1996

1986 LSE and LSHTM offer ‘Joining the staff of

LSHTM in autumn
for the first time a joint graduate programme in 1985, I soon learnt
Health Planning and Financing. about the new
The nine month MSc has two core courses – Basic Masters’ degree
Community Health (mainly taught by Nick Black) that Jenny Roberts
and others had
and Health Planning and Financing (mainly taught
planned. Coming
by Brian Abel-Smith) – and a number of options,
from the Open University, I was
among which Health Economics and Social particularly attracted to it as, unlike
Dimensions of Health. A course in Epidemiology the MSc Community Health, it
and Health Care was also planned but will only be was going to be open to non-
offered from the following year. The first intake medics. One of the four planned
consists of eighteen students. linear courses was entitled ‘Basic
Community Health’, and no one
At the same time… The first WHO had been identified to run it. This
International Conference on Health Promotion was too tempting an opportunity,
particularly when I learnt that
is held in Canada, and the Ottawa Charter
whoever took on the responsibility
is adopted outlining five action strategies on for running it could, to a large
health promotion to help achieve Health for All
by 2000.
extent, determine the curriculum.
Together with Colin Sanderson,
1990 The Health
I put together a course that was Economics and Financing
A major accident at a nuclear plant in Chernobyl, essentially health services research Programme is created
in the former Soviet Union, exposes a vast area and for the next five years or so within the Department of
and population to the effects of radiation. I thoroughly enjoyed being Public Health and Policy
A radioactive cloud sweeps across Europe involved in what was an exciting, at LSHTM, with funding
innovative endeavour.’
prompting an unprecedented health emergency. from the Overseas
Nick Black, LSHTM
Development Agency
(subsequently renamed
DFID). Anne Mills
is the director of
1987 A new the programme.
Department of Public
Health and Policy is At the same time…
created at LSHTM. The NHS and Community
Patrick Vaughan
becomes the first Head
1989 The HPF Care Act establishes an
internal market system
class makes its first
of Department. study trip abroad, to within the NHS and
lake Como, Italy (photo drives the creation of
At the same time… GP fundholding. The
AZT, the first antiretroviral above). Approximately
20 students and 6 GP Contract emphasises
drug, is approved by the role of GPs in
the Food and Drug members of the faculty
participate in the trip. public health and offers
Administration in the incentives for them
US, five years after the This will be repeated in
subsequent years and has to work in health
disease was given its promotion clinics.
current name and amidst now become a regular
growing public anxiety. feature of the MSc. The Romania’s new
latest HPPF classes have government legalises
The World Bank endorses tended to organise trips abortion and maternal
user charges for financing to Geneva to visit the mortality immediately
public health services in main international health declines to 40 per cent
developing countries. organisations. of 1989 figure.

4
1993 – Julian Le Grand joins
the Department of Social Policy
at LSE. ‘I was appointed the
Richard Titmuss Professor of
Social Policy following Brian
Abel-Smith’s retirement. I’ve
taught on HPPF ever since,
with the exception of the
last two years when I was on
secondment to No 10 Downing
Street as health policy adviser to
the Prime Minister. I value many
things about HPPF, including
the range of subject matter
and the breadth of teaching
that the link between the two
Schools allows. But, during
all my time on the course, the
most impressive thing about it
has been the students. Their
diversity, quality and dedication
is quite exceptional in my
experience as a teacher.’
Julian Le Grand, LSE
1992 Lucy
Gilson takes over from
Anne Mills as Course
Organiser for HPF. She
organises the core course
and introduces a Study
Unit on the Political
Economy of Health and
Development. Lucy will
direct the programme for
three years.
At the same time…
The Chinese government
carries out international
competitive bidding for
TB drugs and save 70
per cent on UNICEF’s
published prices.
A major reform of
the Italian National
Health Service devolves
responsibility for the
organisation and
management of health
systems to the regions.
The Indian Government
launches a National AIDS
Control Project.
1993 Charles 1995 LSE celebrates its first centenary, having been founded
Normand takes over in 1895 by Beatrice and Sydney Webb. Ralf Dahrendorf, director
from Patrick Vaughan as of LSE from 1974 to 1984, writes the volume ‘LSE: a history of the
head of the Department London School of Economics and Political Science 1895-1995’ to
of Public Health and mark the anniversary.
Policy at LSHTM.
Franco Sassi (LSE) and Hilary Goodman (LSHTM) become HPPF Programme
Following an Directors marking the end of the joint role previously played first by Anne Mills
intercollegiate review of and then by Lucy Gilson.
the programme during
Anne Mills and Nick Black are promoted to Professors, and Harrison
the academic year
Spencer becomes Dean at LSHTM.
1992-93, the name of
the MSc is changed into LSE Health and LSE Department of Social Policy obtain funding from the
Health Policy, Planning European Commission to develop a Jean Monnet module in European and
and Financing. The core
Comparative Health Policy. This would later evolve into a course on Health
course is also revised and Systems and Policies and become a core component of the HPPF curriculum.
renamed Foundations of
Health Policy. At the same time… The EMEA (European Medicines Agency) is created in
London as a decentralised body of the European Union. Elias Mossialos, LSE,
At the same time... The will be a member of its management board from 2000 to 2003.
Clinton Administration
attempts to implement Germany’s universal Long-Term Care Insurance Program begins.
a major reform of the
The United Nations’ World Summit for Social Development is held in
US health care system.
The attempt will prove
Copenhagen, ending with the Copenhagen declaration and ten commitments
to drive global social progress and development.
unsuccessful.
Free choice of sickness
fund and increased
competition among
sickness funds is
introduced by the Gesund
heitsstrukturgesetz (GSG/
Health Structure Reform
1996 Brian Abel-
Smith dies in London,
Act) in Germany. having been involved in
the life and work of the
The WHO declares
Department of Social Policy
tuberculosis a ‘Global
and LSE Health, and in
Emergency’.
the teaching of the MSc
The World Bank issues
its World Development
1994 LSE Health is Health Policy, Planning and
Financing until the very
established as a research
Report – Investing in last days of his life. He was
centre within the LSE
Health. This will mark an Emeritus Professor of Social
Department of Social
important change in the Policy since his retirement
Policy and Administration,
Bank’s approach to the in 1991.
affiliated with the
development of health European Institute and
LSE Health is recognised as a
care systems throughout the Department of
Collaborating Centre of the
the world, the impact Social Psychology. Elias
WHO on Health Policy and
of which will be felt for Mossialos is the Director.
Pharmaceutical Economics.
many years. Richard Brian Abel-Smith is
Feachem, Dean the main inspirator and At the same time…
of LSHTM, plays a major a driving force behind its Brazil begins a national
role in this endeavour. early development. distribution of anti-
retroviral drugs.
5
 1996-2006
1998 Mrigesh
Bhatia becomes HPPF
Programme Director at
LSE. He will play this role
for three consecutive
years and again in
2004-05.
The European Observatory
on Health Care Systems
is established as a
partnership of the WHO
European Office, the
governments of Norway
1997 Sociologist and Spain, the European
Anthony Giddens Investment Bank, the
(above) becomes LSE World Bank, LSE and
Director, taking over LSHTM. The two Schools
from John Ashworth. form the London hub of
He will remain director the Observatory. HPPF
until 2003. Alumnus Josep Figueras
(HPPF ’89) is appointed
At the same time…
Head of the Observatory
The US Congress passes
Secretariat. (right)
legislation to create a
State Children’s Health At the same time…
Insurance Program The NHS celebrates its
(SCHIP). 50th birthday.
6
2000 Andy Haines becomes
Dean of LSHTM.
Franco Sassi is awarded a Harkness
Fellowship in Health Care Policy by the
Commonwealth Fund (NY, US). This is
the first such award for a member of
LSE, even though others, including future
director Howard Davies, held Harkness
Fellowships before these were targeted
to the field of health policy. Panos
Kanavos will be awarded the same
Fellowship the following year, Anna
Dixon and Adam Oliver in 2005.
LSE Health and the Personal and Social
Services Research Unit at LSE merge
into a new centre called LSE Health and
Social Care. The centre draws upon the
multidisciplinary expertise of 45 staff
members, 15 associated
academics and a number
of postgraduate students.
Elias Mossialos and
Martin Knapp (left) are
co-Directors.
At the same time... The UN Millennium
Declaration sets out the Millennium
Development Goals.
The WHO establishes a Commission on
Macroeconomics and Health (CMH).
Anne Mills is one of 18 leading world
experts called upon as commissioners.
‘The Commission provides evidence that
investments in global health will save 8
million lives a year by 2010 and generate
at least a $360 billion annual gain
during the period 2015-2020, several
times the costs of scaling up the health
interventions themselves, counting both
the donor and recipient country efforts.’
(WHO)
The Bill and Melinda Gates Foundation
is established ‘to help reduce inequities
in the United States and around the
world’. LSHTM will receive funding from
the Foundation to establish the Gates
Malaria Partnership.
 2006 Dirk Mueller (HPPF ’04) takes over from Paul Jacklin as
HPPF Programme Director at LSHTM. For the second time an alumnus
becomes course organiser.

LSE and LSHTM organise a joint conference on 29 and 30 June to

celebrate the 20th anniversary of HPPF and the achievements of the
almost one thousand graduates from the programme. The conference
will focus on ‘20 Years of Health Policy Studies. What Difference Have
We Made?’.

2001 Paul
Jacklin (HPPF ’99) takes
over from Hannah-
Rose Douglas as HPPF
2002 A new
major review of HPPF
programme director at
is undertaken. This will
LSHTM. He will hold this
lead to a change of the
position for five years.
programme from a nine
Alistair month to a one year
McGuire MSc with a compulsory
takes on dissertation (from 2004-
a joint 05), and to a change
position in its structure from
between LSE and 2003-04. Two half unit
King’s College London courses will make up the
as Professor of Health new core, Foundations
Economics. He will of Health Policy, and
gradually move entirely Health Systems and
Policies. Students will be
2003 Elias Mossialos (left)
to LSE and will become becomes the first Brian Abel-Smith
head of the Social Policy able to select options Professor of Health Policy. Howard Davies
Department in 2006. to ‘specialise’ in health becomes director of LSE.
economics, health policy
At the same time… and management, or Gill Walt becomes head of the Public
WTO member epidemiology and Health and Policy Department at LSHTM,
governments adopt the health trends. succeeding in this role to Nick Black. Nick
ministerial Declaration Mays (left) joins LSHTM as Professor of
on the TRIPS Agreement At the same time... Health Policy, upon his return from New
(on Intellectual property HIV/AIDS is the leading Zealand, and is appointed Chair of the HPPF Exam Board.
rights) and Public Health cause of death worldwide
in Doha, Qatar, as a for those aged 15-59. At the same time… Canada begins major health
response to concerns system reform with agreement on the 2003 First
The Global Fund to Ministers’ Accord on Health Care Renewal. During the
about the availability of
Fight AIDS, Tuberculosis, previous year the Romanow Commission published
drugs to patients in poor
and Malaria is formally its Report on the Future of Health Care in Canada,
countries.
established as an recommending major changes to ensure the long-term
‘Mental Health: New ‘innovative approach sustainability of Canada’s health care system.
Understanding, New to international health
Hope’ the 2001 WHO financing’. Richard Cases of polio are reported in six countries: Nigeria,
World Health Report Feachem (photo above) India, Pakistan, Afghanistan, Niger, Egypt.
draws attention to the is appointed Executive
The WHO issues its 2003 Report, Shaping the Future
under-recognised burden Director of the Fund.
(a return to primary health care).
of mental disorders.

7
‘There are few academics who have
changed the world – and even fewer who
have changed it for the better. Brian was
one of that select group.’
Although many individuals were responsible for the
HPPF MSc coming to fruition, the main inspiration
came from the involvement of Brian Abel-Smith.
His work for the British Department of Health and
the WHO convinced him of the importance of social
science principles informing health policy decisions
at international, national and local levels; and the
advantage to social scientists of understanding the
implementation of theoretical ideas at the pragmatic
and policy making levels.
To this end, the multi-disciplinary nature of the HPPF
MSc evolved and was helped by several equally
important factors. First and obviously, the academic
and practical contribution of Brian through his writings,
his influence on government and his encouragement of
students. His ability to cross interdisciplinary boundaries
and place developed and developing country systems
in context was demonstrated by his seminal book Value
for Money in Health Services.
Secondly, the quality, mix and experience of the
students coming on to the MSc. They come, literally,
from all over the world and from all disciplines
– developing and developed countries; social scientists
and clinicians; senior civil servants and recent university
graduates. The MSc attempts to place health, its
determinants and the components of medical and
non-medical health care within the widest economic,
sociological and public policy contexts. Many of its
graduates go on to successful careers in academic and
health care settings.
The productive link with LSHTM is a major component
of the MSc allowing the exchange of ideas between
clinically and non-clinically trained students, to the
benefit of all; and I have no doubts that the teaching
and research staff benefited from the enthusiasm,
experience and commitment of the students to the core
values of the MSc. I feel it has been a privilege to have
been associated with HPPF.
John Carrier, LSE
8
Brian Abel-Smith
1926-1996
Brilliance, modesty and compassion are In Europe, Brian advised all the countries
terms that continually come to mind of the European Community and made
when we reflect on the life of our great a significant contribution to policy
friend and colleague Brian Abel-Smith. development at Community level.
One of his most amazing qualities was He was Special Adviser to a former
his ability to do everything so well yet European Commissioner for Social
with such genuine modesty, whether Affairs, and sat as an independent
it be entertaining, skiing, or advising expert on the EEC Committees on
governments. On a personal level, he Social Protection and Pharmaceutical
radiated warmth in a way which made Consumption. Brian undertook many
it impossible not to notice his presence studies for the European Commission,
when he walked into a room. looking particularly at the organisation,
financing and cost of health care as
Brian’s genius was evident from the
well as cost containment in health care
very beginning of his career. When he
systems. He played a leading role in a
joined LSE as Lecturer in 1955, he was
major study on ‘Choices in Health Policy:
already prominent in the field of social
An Agenda for the European Union’, and
policy thanks to a memorandum to the
up until his death was involved in a LSE
1953 Guillebaud inquiry into the costs
Health study on ‘Priority Setting in Public
of the National Health Service (NHS).
Health and Health Policy in the EU’.
Written with his mentor Richard Titmuss,
whom he succeeded as Professor of But his contribution was not only to health
Social Administration at LSE in 1961, it services. He worked on various aspects of
showed that spending on the still infant housing and social security policy.
NHS, far from spiralling out of control
His work that probably made the
as the Treasury feared, was actually
most political impact was on poverty
falling as a percentage of gross national
‘The Poor and the Poorest’, written
product: and that the pressures of
with Peter Townsend and published in
demography and advances in medical
1965. By demonstrating that despite
science meant that more needed to be
20 years of a welfare state, poverty still
spent on it, not less. It was the NHS
persisted, especially among children
which earned his particular devotion.
and the elderly, it challenged the social
He did more than anyone to acquaint
and political complacency of the day.
others with the reasons for its existence
It led directly to the formation of the
– and how it had to be adapted to new
Child Poverty Action Group and, more
circumstances.
broadly, to an awareness that a coalition
Brian was tremendously active at the of politically aware academics and
international level having visited more welfare activists with a single cause to
than 60 countries as a Consultant for fight for could lead to change.
the World Health Organization and
(Edited from obituary published in
other international organisations; in
Eurohealth, 1996)
consequence, there is hardly a national
system in the developing world that
does not bear the stamp of his advice
and his contributions undoubtedly made
him more influential elsewhere than in
his own country.
The early days
Anne Mills
The birth of the MSc Health Planning and Financing
now seems very long ago! Though in fact I recall it
vividly given that it virtually coincided with the not
altogether straightforward birth of my first child – in
fact, Jenny Roberts had been hoping that I would
start immediately as course director, but instead had
to stand in both as a programme director and lecturer
since I got rushed into hospital in the first term and
then ordered to rest before going on maternity leave
after Christmas. A false alarm, as it turned out, but
rather disruptive at the time!
The start was preceded by many months of planning,
involving mainly, as I recall, Brian Abel-Smith, Jenny,
John Carrier, and myself. We were successful not
only in planning the programme, drawing up the
regulations, and getting it approved, but also in
applying to the university for funding to pay the course
director for three years (I recall termed a ‘new blood’
initiative – to fund new staff for an initial period, after
which School funds had to take over). I was successful
in competing for the position, so not only acquired the
MSc to run, but also moved on to university funding
from research programme funding. As those of you
who are familiar with LSHTM know well, this is a
significant event, eliminating the regular cycle of raising
one’s salary from research grants.
I remember very few problems in getting the
programme through the administration of the Schools,
no doubt due to Brian’s authority and Jenny’s familiarity
with both Schools, though I was fortunate not to bear
the brunt of the negotiations. I don’t think we even
had a formal agreement between the Schools about
the collaboration – that came later. Issues tended to
be solved as they arose rather than thought through in
advance – I recall the problems when the new degree
certificate carried only the LSE name, since LSE was
handling admissions and examinations, and we then
had to work out a way of getting the names of both
schools on the certificate.
Although we now celebrate the course as a programme
in health policy, in fact the word policy was not
introduced into the title until after Lucy Gilson took
over from me as course director, in 1992. In the mid
1980s, the language was of planning and financing.
The core disciplines/subjects were considered to be
health economics, health services, epidemiology, and
sociology, as applied to the health sector. The two
core courses were health planning and financing, run
at LSE, and health services, run at LSHTM. Health
economics, although optional, was taken by virtually
everyone. In many ways the core course has remained
covering many of the same issues as the course we
planned back in 1985 – determinants of health, health
inequalities, sources of finance, approaches to organising
health services, and planning methods. The era of
health care reform brought in new jargon – new public
management, purchaser provider split, contracting out
– but many of the fundamental issues remained
the same.
As originally conceived, the course director held a part-
time post in each School. So I moved between them,
with an office in each place. Certainly the early years
of running the course are now hazy in my memory
– possibly deliberately! My first child was born in
late 1986 and the second in early 1989, so for all the
time I was course director I was juggling babies and
a full time job, as well as in 1990 starting the Health
Economics and Financing research programme with a
DFID (then ODA) research programme grant. I recall
wonderful course secretaries, Sheila followed by Janice
at LSE and Patricia at LSHTM, who bore the brunt of
day to day organisation of the course.
I handed over as director in 1992, not without some
regrets. But it is good to bring in fresh thinking every now
and again, and under Lucy Gilson there was a complete
review of the course, and a considerable strengthening of
the health policy orientation and content.
‘Although we now celebrate the course
as a programme in health policy… in
the mid 1980s, the language was of
planning and financing. The era of health
care reform brought in new jargon – new
public management, purchaser provider
split, contracting out – but many of the
fundamental issues remained the same.’
9
 HPPF@WHO
The World Health Organization was created in 1948
as an Agency of the United Nations. Its aim is the
attainment by all peoples of the highest possible level
of health, defined as a state of complete physical,
mental and social well-being. The secretariat of WHO
is based in Geneva, but the organisation operates
through a network of Regional and Country Offices,
employing around 8,000 people. A large number HPPF
graduates have been and are currently employed at
WHO at all levels of the organisation. HPPF graduates
have played a key role in the establishment and running
In this page we only Juliet Bataringaya-Wavamunno
present a small selection (HPPF, ‘99) In June 2005, I joined a
of HPPF Alumni working colleague from WHO Headquarters
at WHO, it would have and travelled to the Republic of
taken a whole new Yemen to undertake a country
publication to list all evaluation of WHO. As part of the
those who have worked evaluation process, we met and had
and are currently working discussions with various stakeholders
in the Organization, in the health sector. It was with much delight that by
and illustrate their the end of the evaluation we realised there were a
achievements. Hopefully, total of five HPPF graduates, all from different years,
there will be other around the table: Annie Vestjens (HPPF ’97), First
opportunities to do this. Secretary for Public Health, Royal Netherlands Embassy
in the Republic of Yemen; Maria Santamaria (HPPF
’01), Medical Officer, Office of Internal Oversight
Services, WHO Headquarters – Geneva; Jamal Nasher
(HPPF ’02), Director General, Health Policy, Focal Point
for National Health Accounts and Macroeconomics
and Health Ministry of Public Health and Population
Republic of Yemen; Stefan Pahls (HPPF ’03),
Consultant, Health Sector Reform, and Formerly Team
Leader, Support to Health Sector Reform Programme in
the Republic of Yemen funded by European Commission;
and myself (HPPF ’99) National Professional Officer,
Health Systems Development WHO Country Office –
Uganda. We would like to convey our thanks to LSHTM
and LSE for such a wonderful course. It is without doubt
that we shall keep bumping into colleagues scattered
all over the world, working towards improving health
outcomes and health development.
Patrick Kadama (HPPF, ‘89)
is a Health Planner and Health
Economist. He earned a Medical
degree from Makerere University
in 1976 and specialized in Clinical
Tropical Medicine (MSc degree) at
the London School of Hygiene and
Tropical Medicine in 1985. Patrick
pursued a research degree (MPhil) in Health Planning
and Financing under the joint programme at LSE and
LSHTM from 1987 to 1989. He then studied health care
management at the Harvard School of Public Health in
10
of the European Observatory on Health Systems and
Policies, a partnership between the European Office
of WHO and a number of organisations, including LSE
and LSHTM. Josep Figueras (HPPF ‘89) is the Head of
the Observatory. Julia Blau (HPPF ‘04) is a research
officer at the Brussels office, Elke Jakubowski (HPPF
‘97) is research associate at the Observatory and
acting Regional Adviser, Futures Fora, at WHO Europe.
In addition, a number of HPPF graduates have been
working at LSE hub of the Observatory.
Maximillian Mapunda (HPPF,
‘92) has worked for over 16 years
in health systems planning and
managing projects in the health
sector. He has led developments in
health financing initiatives in Tanzania
by participating in the design and
implementation of cost sharing
initiatives, a National Health Insurance Scheme and a
Community Health Fund. He also participated in the
design of health sector reform strategies in Tanzania
and became the first Team Leader of the Health Sector
Reform Secretariat. Maximillian is currently working
with the World Health Organisation Country Office
for Tanzania as National Professional Officer for Health
Systems Development.
Kamel Senouci (HPPF ’03) is
a Medical officer at the WHO
headquarters, based in Lyon,
France. His main focus is on
the implementation of the new
International Health Regulations at
the national level. He provides help
to individual countries to strengthen
their capacities for surveillance and response against
infectious diseases of potential international public
health concern, and participates in WHO missions
during outbreaks.
1994. He was involved in Health Policy development
and Health Planning in Uganda for over 15 years as
head of health sector planning in the Ministry of
Health. Patrick has also been involved with public
expenditure reviews; with the development of national
health accounts; poverty reduction strategies; burden
of disease and health sector performance assessments;
the development of health financing strategies and
sector wide approaches for health development. He
is currently working at the World Health Organization
Headquarters in Geneva, in the Department for Health
Policy, Development and Services.

Ole Doetinchem (HPPF ‘02). When studying on
HPPF, we would at times joke that the health policy
and the financing bits of the master’s programme
received more attention than the planning aspect.
Consequently, it was more by chance than by planning
that I found myself back in my native Germany working
for GTZ after graduation. After a happy three years
there, however, it was time for a change of scene. So,
in 2005 I took up the post of health systems analyst
in the health financing department at the WHO
headquarters in Geneva. In a nutshell, this job entails
seeking and disseminating information on how to best
organise the financing function of health systems, both
in general terms (what systems exist, how do different
policies work, what choices need to be made, etc.)
and in country-specific settings (reviewing proposed
laws, assessing the financial implications and options
given a countries’ circumstances, capacity building,
etc). The work at WHO is very much demand-driven. I
don’t have one specific geographical focus but work to
satisfy the needs of WHO member states and regional
bodies. This allows me to assess health financing in a
wide range of different places, eg, recently in Yemen,
Rwanda (see photo, above, taken during the mission,
with Jean de Dieu Ntabakirabose) and the Philippines.
The HPPF programme has given me an invaluable and
thorough grounding in exactly the area that I now work
in. What’s also great about it is that you invariably meet
other HPPF graduates along the way…
Alexandra Pitman (HPPF ’98)
Studying on HPPF was an extremely valuable
experience. I learnt as much about the principles
of health policy, health economics, health services
management, and epidemiology from fellow students
as from the lecturers. Armed with this knowledge, I
went straight back to the beginning and started at
Imperial College School of Medicine the following
autumn. Whilst there, terms like ‘sixth stool guiac’ and
‘list cancelled’ developed a little more context, and
I began to understand the forces guiding individual
clinicians at the micro-level of decision-making. Most
importantly, I realised that for practising clinicians, any
decision made about an individual patient does not
seem ‘micro’ at all. I witnessed how policies issued
from up high were received on the ground, and how
important it was to consider implementation if policy-
making was not to be a complete waste of time.
My research interests are now focused on mental health
policy, specifically on suicide prevention, as a psychiatrist
on the Charing Cross Hospital Training Scheme. The
research base for this is scant, both because suicide is a
relatively rare event and because it is a behaviour rather
than a diagnosis. Using the experiences and knowledge
I obtained while studying on HPPF, I am trying to find
a way to develop clinical guidelines that are the best
reflection of the evidence available, applicable to specific
sub-groups, presented in a clear and up-to-date format,
and acceptable to clinicians.
Anne Philpott (HPPF ‘99)
After finishing the HPPF course part-time, I resumed
work for an international sexual and reproductive
health NGO for a short while before moving to Sri
Lanka. There, I served as the Director of International
Programmes for an international NGO that works in
Asia and Africa but is based in Colombo. Following this,
I went on to work for the Female Health Company, the
sole manufacturer of the female condom, as the Team
Leader for their global public sector programmes. They
have a low cost agreement with UNAIDS for work in
low income countries, which gave me the opportunity
to travel extensively in Africa and Asia introducing
this new health technology. I worked on building
government and service delivery organisation skills to
promote and deliver the product, helped it to achieve
regulatory approval, oversaw donor negotiations, and
helped shift the first stage of manufacturing to India.
While doing this, I was based in Sri Lanka and Thailand,
with extensive travel in India and elsewhere. I then
moved back to the UK and am now working as the
Health advisor in the AIDS team at the Department
for International Development (DFID). I advise on
international policy issues, work with multi-laterals
and country programmes, provide advice to
spending departments on Health/AIDS issues, and
deal with parliamentary business and briefings to
Ministers and Senior Management. So since HPPF
I have covered all bases by working for NGOs, in
the private sector, and now as a civil servant.
11
 GENERATING NEW SCIENCE FROM
KNOWLEDGE AND EXPERIENCE

Here is a small selection of publications in scientific journals and books

by HPPF Alumni. Just one of the many ways in which the programme
and those who graduated from it have made a difference in health
policy worldwide.

12
13
 Valeria Oliveira Cruz HPPF @ LSHTM

The London School of Hygiene & Tropical Medicine Sub-Saharan African countries until he left HPU to
(LSHTM) is Britain’s national school of public health join the World Bank as a Young Professional. Valeria
and its Department of Public Health and Policy has Oliveira Cruz (HPPF ‘00) started working immediately
hosted the MSc HPPF since its inception together following her graduation from HPPF also as part of
with LSE. A number of graduates of the MSc HPPF the operational team of Working Group 5 of the
have joined the staff of LSHTM either in the Health Commission on Macroeconomics and Health. Later she
Services Research Unit (HSRU) or the Health Policy Unit joined the Health Systems Development Programme
Dirk Mueller (HPU). The research performed in HSRU ranges from of HPU and has focused her work on the topic of aid
epidemiological and economic assessment of specific effectiveness in the health sector. Lorna Guinness
health technologies, through sociological studies of (HPPF ‘96) joined the Health Policy Unit in 2001 and
approaches to providing care, to the evaluation of is a Wellcome Trust Research Fellow. Her research
health sector reforms. The Health Policy Unit focuses focuses on the economics of scaling up HIV prevention
on comparative health policy and health systems programmes in South India. Dirk Mueller (HPPF ‘04)
analysis, health economics and international public joined HPU in 2004 to work on a review of health
health; its work is particularly concerned with Low- financing research. Being part of the Health Economics
and Middle-Income Countries. The Unit hosts four and Financing Programme, he has since carried out
main programmes: health economics and financing, several cost-effectiveness studies with a particular focus
health systems development, violence and public on methods of malaria prevention in East and West
health as well as modelling and public health. Africa. Since 2006, he is also LSHTM Course Organiser
for the MSc HPPF. Among other HPPF Alumni who have
Paul Jacklin (HPPF ’99) was based in HSRU from
worked and are working at LSHTM are Ros Plowman
Lorna Guinness September 1999 to December 2005. He worked as
(HPPF ’93) in the Health Services Research Unit, and
a health economist on the world’s largest RCT of
Cathy Zimmerman (HPPF ’99) in the Health Policy Unit.
telemedicine and became Course Organiser for the
MSc HPPF in 2001, a position which he held until the
end of last year before leaving to take on the role of
senior health economist at the National Collaborating
Centre for Women’s and Children’s Health. He
continues to have links with LSHTM with a honorary
lectureship. Natasha Palmer (HPPF ‘96) joined the
Health Economics and Financing Programme in 1997.
Her research interests include: public/private mix of
health service provision, contracting, barriers to access
of health service and systematic review of financing
research. Christoph Kurowski graduated from HPPF
in 2000 and joined the same year a HPU based team
that performed the analytical work of Working Group
5 (Improving Health Outcomes of the Poor) of the
Commission on Macroeconomics and Health. He also
studied the human resource implications of achieving
health related Millennium Development Goals in Natasha Palmer Paul Jacklin
14
HPPF @ LSE

Several HPPF alumni have found Derek King (HPPF ’98) has been a
employment at LSE Health and Social Research Officer since 1998. Derek’s
Care, a multi-disciplinary research primary area of research is in mental
centre in the Department of Social Policy health policy and economics, with a
at LSE, and the European Observatory particular focus on service use patterns
on Health Systems and Policies. The and the costs of treating schizophrenia.
Observatory supports and promotes He also works on modelling projections
evidence-based health policy-making of long-term care expenditure. Other
through comprehensive and rigorous interests include pharmaceutical policy,
analysis of the dynamics of health priority setting in health care and private
systems in Europe. It is a partnership health insurance markets. Alexandra
between the WHO Regional Office for Pitman (HPPF ’98) was an Occasional
Europe, the governments of Belgium, Researcher from 1999 to 2000. She
Finland, Greece, Norway, Spain and worked on cost containment and health
Sweden, the Veneto Region of Italy, the impact assessment in Europe and US
European Investment Bank, the Open health care reform while training to be
Society Institute, the World Bank, CRP- a doctor. She is now a Senior House
Santé Luxembourg, LSE and LSHTM. Officer in Psychiatry on the Charing
Cross Psychiatric Training Scheme and
Vanessa Davey (HPPF ’02) has been
doing research into suicide prevention
a Research Officer at LSE Health and
policy. Sarah Thomson (HPPF ’98)
Social Care since 2002. She has been
has been a Research Officer since
focusing on the impact of social care
2000. Sarah works for the European
commissioning on service user control
Observatory on Health Systems and
and choice. She is currently leading an
Policies and is also involved in a LSHTM-
evaluation of the introduction of cash
based project providing policy analysis
payments to service users for the UK
and advice to the UK Department of
Department of Health. Anna Dixon
Health. Most of her research focuses on
(HPPF ’98) has been a Research Officer
analysis of public and private sources
and Lecturer in European Health Policy
of health care funding in Europe, in
from 1998 to 2006. Anna is completing
particular the role and impact of private
a Harkness Fellowship in Health Care
health insurance and user charges.
Policy in the United States on the use
of information by patients. Upon her
return to the United Kingdom she will
take up the post of Deputy Director of
Policy at independent health foundation
the King’s Fund. Her current research
interests focus on patient choice and
activation, health information and
health care regulation. Tom Foubister
(HPPF ’03) has been a Research Officer
since 2004. He has analysed the UK’s
private health insurance market for
the UK Department of Health and
health financing in Central and Eastern
European countries for WHO. He is
currently looking at issues of access Anna Dixon
to health care in the European Union.
Kate Henderson (HPPF ’02) has been a
Research Officer since 2002. She focuses Left to right: Kate Henderson,
on intermediate care, the interface Tom Foubister, Sarah Thomson,
between health and social care, resource Derek King, Franco Sassi
allocation within residential and nursing
homes and residential care provision.
 Viroj Tangcharoensathien (HPPF ’90)
I would define myself as a health systems and policy
researcher. I currently direct the International Health
Policy Program at the Ministry of Public Health in
Thailand. After obtaining a Doctorate of Medicine
from Mahidol University (1980) and serving seven
years in rural district hospitals in Thailand, I decided
to pursue doctoral training in Health Planning and
Financing and was able to do so in 1987-1990 through
a Rockefeller Foundation fellowship. My doctoral
thesis, Community Financing: The Urban Health Card in
Chiangmai, Thailand, received the Woodruff Medal in
1991 as outstanding PhD thesis of the London School
of Hygiene and Tropical Medicine. Upon my return to
Thailand, I focused his work on research into financing
healthcare and health insurance development and
reform. I created the National Health Account and
National AIDS Account, and proposed a contract model
and estimated capitation rates following the inception
of Social Health Insurance in 1991.
I have had a close research collaboration with Anne Mills’
Health Economic and Financing Program since 1992, and
recently became a member of the Consortium for Research
on Equitable Health Systems. The collaboration has proven
very fruitful in aiding the research of young Thai scholars who
became instrumental in health systems reforms in Thailand.
I am now on secondment to head the International
Health Policy Program, aimed at capacity building in
health systems and policy research. I work closely with
other Thai policy makers in the reform of the current
Universal Coverage system, and I provide technical
support to health insurance development in Lao,
Vietnam and Cambodia.
16
Notburga Timmermans (HPPF ’98)
Graduating from HPPF helped me to get a job with
the British Department for International Development
(DFID) in Tanzania as Assistant Health Adviser, where
I was able to implement many of my new skills. The
aspects of the MSc that turned out to be most relevant
to my future career were health sector reform, sector-
wide approaches, health financing, and health service
management.
Since then, I’ve worked as a freelance consultant
in the area of health systems and multi-sectoral
HIV/AIDS in Africa and Asia. HPPF has assisted me in
obtaining interesting work. Some examples of this
include: providing assistance to the Danish Agency
for International Development (Danida) in the
development of their new five year strategy for support
to the health sector and HIV/AIDS interventions in
Mozambique; setting up a programme for the creation
of a sustainable commercial market for Insecticide-
Treated Mosquito Nets in Mozambique; assisting a
Mozambican network of HIV/AIDS organisations in
developing their five year strategy and mobilising donor
funding; developing the strategy for capacity building
in financial management of health services in Santiago-
Nord province in Cabo Verde; assisting the Swedish
International Development Agency (Sida) in developing
their five year HIV/AIDS strategy for Mozambique;
helping the Mozambican Ministry of Health to develop
a system for direct contracting of NGOs for service
delivery; developing action plans for urgent malaria
interventions in Malawi, Benin and Mali; and taking a
secondment to UNAIDS to set up a joint-donor HIV/
AIDS Fund in Myanmar.
In Mozambique I also met my husband Danny, whom
I married in June last year. A number of former
HPPF classmates were present at our wedding (in
the photo below, from the left, Derek King, Anna
Dixon, Alexandra Pitman and Anne Philpott). I will
always remember my year in HPPF for the academic
stimulation it provided and the wonderful friendships it
has left me with. Congratulations to the
HPPF staff for the 20 years of this
wonderful course. May the course
continue to provide guidance
for many more generations of
students from all over the world.
From Planning to Policy
Lucy Gilson

I was HPPF course organiser from 1992 to 1995. good to get news of ex-HPPFers. I also still continue
During that time three cohorts of students passed to listen to CDs on the CD Walkman given to me as a
through the doors of LSHTM and LSE, and the course present by the last student cohort I saw through – so
name changed to include the extra P, adding policy thanks again!
to health planning and financing.
Other features of my years as course organiser that
The addition of the extra P resulted from a review of stand out for me were the luxury of an office of my
the course as a whole, drawing on staff from both own for two days a week in LSE (compared to shared
Schools. In part the review sought to update the office space in LSHTM), the regular exercise of walking
course to reflect the changing world environment. The between the two schools, the enormous support
additional P reflected the recognition that planning is and shared camaraderie of the course secretaries,
a very political activity, even if also needing technical Janice Harrison and Tricia Foley, in both schools, the
skills. In addition, the review allowed reflection excitement of the year the first democratic South
on some of the inevitable logistical issues that are African elections were held (1994) and the associated
associated with any course, especially one run across difficulty of studying for some in the class, and the
organisations and on different sites. Having to support warm collegiality of Anne Mills, Jenny Roberts and
it early on in my life as a course organiser was a great others at LSHTM as well as Julian Le Grand, John
baptism into the procedures and approaches of both Carrier and colleagues at LSE.
schools, each of which has its own organisational
I took over as course organiser from Anne in 1992,
culture. It also enabled me to get to know my new
fully aware of the legacy of the course and having
colleagues at LSE as I was appointed from an LSHTM
just completed my own PhD. I handed over as course
base into a joint position with LSE.
organiser to Franco Sassi and Hilary Goodman in 1995,
The review led me to think through the particular roles enriched by the experience and the people, and en
I wanted to play in the teaching programme – both route for South Africa – where I have been ever since.
in terms of organisational approaches and in terms Here I continue to have contact with African ex-HPPFers
of the topics and issues I felt important to include. and have continued to encourage others to take the
Subsequently, I contributed to the revision of the course, as an excellent grounding for a career in health
Foundations of Health Policy core course, also running management or research.
the developing country seminar stream for this course,
Although I cannot be physically present in London for
and developed a module on the Political Economy of
this year’s celebrations, I will certainly be there in spirit
Health run at LSHTM, linked to the Term 1 course on
– remembering a period that was a central building
Health Policy, Process and Power. The FHP lecturing
block for my professional life.
forced me to come to grips with a wide range of
topics – about some of which, I admit, I knew little. I
well remember the embarrassing moment when I was
asked a question at the end of a lecture on drug policy:
I not only had no clue of an appropriate answer but
well knew that there were at least 3-4 people in the
room with the depth of experience of drug policy that
meant that they should have been giving the lecture!
However, teaching such a breadth of subjects and, in
particular, the development of the political economy
module provided me with an excellent basis for the
work that I have done since that time. The learning-
through-doing around teaching practice and course
development also provided an excellent grounding in
‘I well remember the embarrassing moment
course development that has stood me in good stead.
when I was asked a question at the end
As course organiser I particularly enjoyed getting to of a lecture on drug policy: I not only had
know the many students who did HPPF. Such a rich
no clue of an appropriate answer but well
group of people and such a diversity of experience!
Given quite large class sizes, I never felt that I was
knew that there were at least 3-4 people
fully able to keep in touch with those who took the in the room with the depth of experience
developed country stream. But I did try to keep in touch of drug policy that meant that they should
with those doing the course part-time, as well as those have been giving the lecture!’
from the developing country stream. It’s still always
17
 1

7
26

7 153 13
12 24
1
16 3

1
70 2 25

1 2
21 1 3
1 1
2 1
8
1 2 11
1
3

7
9
Student nationalities
Students have joined HPPF from many countries in
all continents. The map in these pages shows the
nationalities of those whose details we were still
able to track down. The mix of countries has changed 3 1
significantly over time, as shown by the two pie
charts covering the first and the last ten years of
the programme.

18
 3 1

2
1

2
1 1 1
4 1
1
10 2 1
4 1
17 7 1
3 15
3
1

9 1
1 1
2 11 4
16 2 1

1 3 8 2
4
3 3
1 6
12 1
9 3
1
3 2

4 1 1 1
1 1
5
2
12 1

1986-1996 1996-2006
Africa Africa
Australia and UK
New Zealand Australia and
North North New Zealand
America Central and America
UK South America Central and
Asia Rest of Europe South America
Asia
Rest of Europe

19
 Rob Anderson (HPPF ’98)
For me, HPPF provided a number of things, which,
in one way or another, have influenced my research
career. Firstly, the course on economic evaluation
brought out my latent geekish tendencies (i.e. a love
of decision modelling) such that almost nine years later
I still spend way too much time fiddling with cost-
effectiveness models and running endless ‘what if’
health policy scenarios. As a consequence and perhaps
bizarrely, I now find myself in a job with the words
‘health economist’ in the title. Secondly, HPPF further
strengthened my commitment to policy-relevance in
everything I do, and examination of the translation of
research findings into policy has become a recurring
aspect of my work. It is no gimmick that so many HPPF
courses have the words ‘...for policy-making’ in their
title. Thirdly, HPPF allowed me to further indulge in my
‘hobby’ of international comparative health systems
analysis, perhaps culminating in my decision in 2001
to live and study in Australia for four years (okay, so
the sunshine and easygoing lifestyle helped). There’s
nothing better for reflecting on your own health
system with fresh eyes than immersing yourself (and
having babies!) in a different one. Asking why we
do things differently here versus there, and trying to
measure what difference it makes, still forms a central
theme to much of my work. Finally, of course, the MSc
put me in touch with a great bunch of people from all
over the world who are similarly impassioned about
understanding how health systems work, how health
services can be evaluated and changed, and how
ultimately we might create health policies that make a
positive difference to people’s health. You can see me
crabbing at Dittisham on Dart Estuary in the picture.
Silvana Castaldi (HPPF ’89)
In the 1980s it was not usual for Italian students to study
abroad. A friend told me about HPPF and I immediately
decided to study in London. I flew from Novara, near
Milano, to reach London with merely a knowledge of
formal English – phrases such as ‘Where is the station?’
and ‘This is my pencil.’ Once in London, however,
nobody asked me anything about stations or pencils.
In 1988, only two Italian students were in the HPPF MSc –
one focused on developing countries and myself focused
on developed countries. Language was not a problem,
but learning to navigate the English university teaching
system proved to be a big challenge. Choosing courses
was very difficult, and nothing resembled the Italian
structure of seminars and tutorial that I was used to.
During the first term, I chose a course titled ‘The Gift
Relationship,’ offered by the department of Social
Anthropology. At the time, I thought, ‘We are in autumn
and this will be the perfect method for drawing up my
list of Christmas presents.’ The course was not exactly
20
what I had expected. Instead, I found myself studying
anthropologists’ points of view about the relationship
between human beings. ‘The Gift Relationship’ has
nothing to do with Christmas; instead it is the starting
point of a very nice essay about blood donors.
I do not wish to remember now the hours and hours I
spent in the library (that still I consider the best in the
world) studying many marvellous topics I had never
before encountered. It was a year spent studying only
what I loved and still love. Yet, there is another place in
LSE that I grew to love so much. At the Shaw library, I
began to appreciate drinking tea, reading with classical
music, and sleeping surrounded by the sound of the
rain. It is perhaps these memories that I cherish the
most from my experience as an HPPF MSc student.
Øystein Evjen Olsen (HPPF ’98)
The blackness of the night is intense on your eyes
in the Tanzanian bush. Equally intense is the job of
managing and directing Haydom Lutheran Hospital,
a rural 400 bed hospital with basically all referral
functions, situated more than 300 kilometres from
the nearest town, Arusha. With more than 11,000
inpatients, 80,000 outpatients, 3,300 deliveries,
75,000 children, and 25,000 mothers seen through
the outreach Reproductive and Child Health Services
alone, and more than 350 patients on ART, 65 villages
in the HIV outreach services, 22,000 blood slides, and
470 staff, we keep our days occupied as challenges
continue to come at us. Basically all possible challenges
and theoretical topics studied at LSHTM and LSE
are present in their often dramatic realities. Policy,
planning, and financing challenges are present every
day and every hour. Turning vertical interventions into
horizontal services, managing priority setting processes,
and improving cost efficiency are essential to keeping
the hospital alive. But perhaps most importantly, HPPF
taught me the lingo necessary to please development
partners, ministries, and donors. Translating the daily
routines and activities into a language understood
by all is a major challenge. My colleagues at the
hospital know what to do and why they are doing
it; their struggle has been to tell this to the rest of
the world. Why is it so difficult for policy makers and
development thinkers to understand that they, my
colleagues, share their vision and objectives? This is
probably where I matter the most, as I humbly watch
my colleagues operate on complicated brain tumours,
treat multiresistant infections, deal with HIV positive
patients, and see children dying of pneumonia and
malnutrition. Knowing how it all can come together
into creating understandable and meaningful processes
for sustainability, equity, efficiency, quality, and trust –
I am forever grateful for what I learned in London.
HPPF @ NICE

Working at the National Institute for Health and Clinical health technologies, critically assess the evidence
Excellence (NICE) is an exciting experience and quite a submissions provided by the manufacturers, and write
privilege! NICE as an organisation is often in the news national guidance based on our standing Committee’s
– although not always depicted the way we would want discussions on the technology in question.
it – and has international standing in the field of health
NICE is an ideal place to put in practice the knowledge
technology assessment. A privilege because NICE is
and skills (eg, the principles of cost-effectiveness
a national agency that issues guidance to the NHS in
analysis) we acquired while studying on HPPF. The
England and Wales on a number of challenging subjects.
MSc gave us insights into the operation of health care
About 200 people are working for NICE in two locations:
systems across the world, and especially the NHS in the
London and Manchester. NICE has perhaps attracted
UK. Working at NICE brings into sharp relief the tension
most attention over its appraisals of pharmaceuticals,
between a cash constrained system and the demands
but this ‘arms-length body’ is responsible for many
of patients and others. The Appraisals team and NICE
other activities associated with enhancing the quality
more widely, are comprised of individuals with a
of healthcare and preventing ill health.
variety of backgrounds. Consequently we learn from
Over the years we have managed to get quite a each others expertise in areas such as epidemiology,
contingent of HPPF alumni interested in working for systematic reviewing and clinical medicine. This helps
NICE. As of this month, there are five of us: Kate to make NICE the dynamic and exciting place it is. Have
Burslem, Helen Chung and Ebenezer Tetteh (HPPF a look at www.nice.org.uk if you want to know more
‘05), Meindert Boysen (HPPF ‘03) and Francis Ruiz about the Institute and what we do.
(HPPF ‘01). We are all working within the Technology
Appraisals programme as part of an ever expanding
team of Health Technology Analysts (currently 10).
With the involvement of our stakeholders, we set
the boundaries (scope) of each technology appraisal,
support the development of independent academic
reports on the clinical and cost-effectiveness of
21
 HPPF @ GTZ

The Deutsche Gesellschaft für Technische Government of the North-West Frontier Province in
Zusammenarbeit (GTZ) GmbH is an international Pakistan on decentralization, hospital autonomy, quality
cooperation enterprise with worldwide operations. It management and health financing with particular
provides viable, forward-looking solutions for political, emphasis of introducing social health insurance. After
economic, ecological and social development in a having worked for the last ten years with GTZ in Islamic
Bernd Appelt globalised world. GTZ promotes complex reforms countries in Africa and Asia he has developed a special
and change processes, often working under difficult interest of looking at health reform processes from
conditions. Its corporate objective is to improve an Islamic perspective. He has started his career in
people’s living conditions on a sustainable basis. GTZ’s 1987 as a clinician in a district hospital in Zimbabwe.
services span a wide range of activity areas, from He sees the key to the solution to the poor health
economic development and employment promotion, situation in many developing countries not only in
through governance and democracy, health and basic the health sector, but also rather in the general and
education to environmental protection, resource especially finance politics and policies of a state. The
conservation, agriculture, fishing and nutrition. HPPF course has equipped him with the knowledge
In all the activity areas GTZ helps to enhance the to better understand the relationships between
capabilities of individuals and organisations. GTZ’s core health, politics, power and financial systems. Burkard
interventions and advisory services in the health sector Kömm (HPPF ‘01) has been working from August
focus on health system development, health sector 2001 until August 2004 as the CEO of a regional
reforms (including financing and decentralisation), health insurance in the South East of Nigeria. His task
Thomas Kirsch-Woik
social equity and orientation within the services was to reform an existing health scheme owned by a
towards the poor, quality management and human catholic congregation and to expand it regionally as
resource management, sexual and reproductive health, well as to develop a proposal for a national approach
control of infectious diseases (particularly HIV/AIDS), to the question of health care financing in the vast
health promotion and urban health. sector of Faith Based health care providers in Nigeria.
Since October 2004 Burkard is working in Nairobi as a
Since graduation from HPPF Nina Siegert (HPPF
technical advisor in a GTZ/Government of Kenya project
‘03) has been working as health-financing consultant
on health care financing and global financial support in
for the GTZ Health Financing Component in
health. His task is to provide support for the development
Tanzania. Within the German supported Health
of effective linkages between national financing
Sector Programme, she gives direct support to the
mechanisms in health and global financial support.
government’s health sector reform process with a main
focus on strengthening the social health insurance
system. This includes direct support to the organisation
Nina Siegert
and management of Community Health Insurances at
district level and the National Health Insurance Fund at
national level. Thomas Kirsch-Woik (HPPF ‘00) holds
a position as senior health consultant giving policy
advice mainly to the leadership of the German Federal
Ministry of Economic Cooperation and Development
in Berlin on HIV/AIDS and Health Issues. He worked
for many years as senior manager on health system
development (and later HIV/AIDS) at GTZ head
office in Eschborn, Germany with special interest on
contracting, health financing, community participation
and health sector reform. He spent more than six years
in developing countries, mainly in Madagascar advising
Burkard Kömm and supporting a District and Reproductive Health
Project. Ole Doetinchem (HPPF ‘02) worked at GTZ
in the area of international cooperation and health
insurance. During his three years at GTZ, Ole’s work
focus shifted from advocacy towards predominantly
technical work on health insurance in developing
countries. He left GTZ in 2005 to take up a post at
WHO. Bernd Appelt (HPPF ‘00) currently works for
GTZ as a technical advisor at the Health Sector Reform
and Research Unit of the Department of Health of the

22
Angela Burnett (HPPF ’96)
I am a GP at the Sanctuary Practice in Hackney, East
London, which was originally established to provide
a dedicated service for asylum seekers and refugees
and which now caters for a wider practice population.
I have also worked at the Medical Foundation for the
Care of Victims of Torture since 1994. I provide training
on the health care of refugees and torture survivors
and have assisted in the development of health services
throughout the UK. Previously I worked in Zambia,
providing health care for people affected by HIV/
AIDS and their families and researching collaboration
between traditional healers and formal health workers.
I also worked in Macedonia evaluating a professional
development programme for doctors and with Oxfam
in Ethiopia, with people affected by drought and
famine. With RETAS (Refugee Education and Training
Advisory Service) I provided mentoring support for
refugee doctors, in order to assist them to work in
the UK. I regularly write on the health of refugees and
survivors of torture, including a series in the British
Medical Journal, several book chapters, guidelines and
a resource pack for health workers. I have a two year
old daughter, Lili, and like singing, dancing and long
cycle rides. You can see me in the centre of the picture
as I receive the NHS ‘Outstanding Achiever of the Year’
award as a primary care professional in 2004.
Monica Davoli and Geert Haghebaert
(both HPPF ’97)
Whenever we meet new acquaintances, we are
asked where we are from (our accents still betray us).
Unmistakably, when informed that one is from Brazil
and the other is from Belgium, they suppose somehow
we met in Brazil or another tropical destination. Every
time our answer is prompt: No, we met in London
while studying at LSE and LSHTM, actually! The
resulting ‘Oooh!?’ consistently leads us to talk about
our HPPF Master’s course – now ten years behind us
– and the different paths in life that led us there. We
were both able to enrich our previous experiences
thanks to the course and its participants. We also admit
that our lives changed significantly when we fell in love
in London. Indeed, we hardly can limit ourselves to a
short and factual description of what is just about one
year in our lives.
Perhaps it is not a day-to-
day situation in which a
Brazilian specialist in public
administration working in
the federal health ministry
with World Bank funds
joins life with a Belgian
trained medical doctor
working with NGOs in the
humanitarian sector. One of us – eager to strengthen
knowledge about health and specific issues in the
field of health economics, and the other – desperately
seeking to understand how to be more effective. Both
of us feel much more comfortable these days though,
thanks in part to the solid teachings of the HPPF course
as well as the in-depth exchanges brought about by the
different backgrounds of its participants.
Monica left the Federal Ministry in Brasilia to join Geert
in Bosnia Herzegovina (quite an unexpected result of
HPPF). We quickly moved on working, with both of
us taking some spells as ‘spouse’ for some time when
our children were born. Ever since our time in London,
people look a bit surprised to hear our story of lives
turned upside down. We always confirm this is not due
to, but rather thanks to, HPPF.
Ariel Frisancho (HPPF ’02)
As a medical doctor with 12 years of experience
working for various health and social development
projects in Peru, taking HPPF helped me to improve my
analytical skills and understanding of the underlying
processes that cause health sector reforms to fail
or succeed. I initially applied the new knowledge,
especially what I learned through discussions in the
European and Comparative Health Policy course,
working at Health and Life Sciences Partnership, an
international organization that provides technical
assistance to health sector reform processes in 30
countries. I also became a lecturer in Health Policy on
MSc courses for several Peruvian universities.
Since 2004, I have been the Project Manager of a
DFID-funded Peruvian health rights program run by
CARE. The project goal is ‘to improve the health of
the poor and excluded population of Peru through the
improvement of the relationship between Peruvian
society and the state’. Through better relationships
and improved interaction with state officers, citizens
will become involved in the health policy design
and implementation process. This project shows
the importance of public participation as a principle
that contributes to more inclusive social policies. It
provides an analysis of conditions and factors that
may influence the success of public participation for
strengthening governance and rights engagement.
Working with both health professionals and the public
has been an enriching professional experience, and the
knowledge that I gained through the Health Policy,
Process, and Power as well as the Primary Health Care
courses has been of paramount importance in this
work. The project has been recognized as one of CARE
International’s twelve innovative programs employing
rights-based approaches.
23
 LSE Health Society Launches Alumni Network
The LSE Health Society has created a formal network As part of the network’s activities, an annual Health
of alumni in June 2006. Membership of the Health Alumni Reunion Conference in London is planned as
Alumni Network is open to past and current students well as a high level speaker series organised by the LSE
of International Health Policy, Health Population & Health Society. We aspire to expand the network’s
Society and Health Policy, Planning & Financing taught function to organisation of regional reunions and
Masters Courses, as well as health teaching staff at events with the support of enthusiastic local volunteers.
both LSE and LSHTM. The aim of the Network is to
To get involved and for further details on the Alumni
provide a platform for global networking, focused
Network please contact either: Samia Saad, LSE Health
career advice and alumni professional mentoring
Society Alumni Network Officer (MSc IHP 2005/2006);
through a private database and a series of events. The
or Leon von Brasch, LSE Health Society Chairman
database will be password protected for alumni and
MSc HPPF 2005/2006. Please address your queries to
staff and abide by EU data protection legislation. It will
the email address: health.society@lse.ac.uk
be hosted by the LSE Health Society website and linked
to LSE Health and Social Care to maintain good links
and coordination with the relevant LSE and LSHTM
academic departments.

Other Graduate Programmes offered by LSE and LSHTM

After the establishment of a joint degree in Health Policy, Planning and Financing in 1986, both LSE and LSHTM have expanded their
offer of taught programmes in the field of health policy. Here is a brief description of the main programmes available at the two
Schools, more information and application forms for these and for HPPF can be found on the respective Web sites (www.lse.ac.uk
and www.lshtm.ac.uk).

LSE, Department of Social Policy LSHTM, Department of Public Health Policy

In the MSc International Health Policy, offered by LSE, gives students
the opportunity to examine current and emerging health policy issues
through the application of basic health policy and economic principles.
The MSc International Health Policy (Health Economics) allows
students to concentrate in more detail on options geared to health
economics analysis. For both the Health Policy and Health Economics
streams of the MSc, opportunities are provided for internships with
major international and governmental organisations, companies
or academic institutions as part of the overall student assessment.
Professional destinations after graduation include consultancies,
pharmaceutical companies, national health services, international
organisations and government departments and agencies as well as
employment in research or further study for a PhD.
The MSc Health, Population and Society, also offered by LSE,
provides state-of-the-art training for population and health issues, both
substantive and policy related. In the last 50 years the improvements in
health have been dramatic in both developed and developing societies.
As a result the average life expectancy of human populations has
increased rapidly. Western societies are being faced with an ageing
population, in a new demographic regime of low mortality and low
fertility. While some developing societies in Asia and Latin America are
following this experience, most of Sub-Saharan Africa is experiencing
a mortality crisis as a result of the escalating HIV/AIDS epidemic.
This MSc addresses the implications of health and mortality trends
for health policy making and the broader economy, adopting a
multidisciplinary perspective.
The MSc Public Health, offered by LSHTM, covers the whole breadth
of public health and allows students to follow a general stream of study
(Public Health stream), which focuses mainly on high- and middle-
income countries, or to concentrate on one of four other streams
(Environment and Health stream; Health Promotion stream; Health
Services Management stream; Health Services Research stream).
Students on this degree will be able to select teaching modules from
a variety of areas such as Epidemiology, Health Economics, Social
Research, Health Services, Health Policy, Health Promotion.
The MSc Public Health in Developing Countries, also offered by
LSHTM, aims to equip students with skills to analyse public health
problems in developing countries and design and evaluate actions to
improve public health. It combines the research and teaching strengths
of the School’s academic departments and considers issues related to
health, development and the provision of health services from a broad
multidisciplinary perspective. Students are expected to have been
involved in the planning or implementation of health programmes in
developing countries, in teaching or in research. Every year the course
attracts experienced health professionals from around the world.
In addition to the degrees offered within the Department of Public
Health Policy, other MSc courses at the School may be relevant to
students with a public health interest including: MSc Public Health
Nutrition, MSc Epidemiology, MSc Control of Infectious Diseases
among many others.

24
2005-06 2004-05 2003-04 2001-02 1997-98 1996-97
Department of Public
Health and Policy
London School of Hygiene
and Tropical Medicine
www.lshtm.ac.uk/php/
Tel: +44 (0)20 7927 2432
Fax: +44 (0)20 7436 3611
Department of Social Policy
The London School of Economics
and Political Science
www.lse.ac.uk/collections/socialPolicy/
Tel.: +44 (0)20 7955 6169
Fax: +44 (0)20 7955 7415
LSHTM Alumni Association
www.lshtm.ac.uk/alumni/
Email: alumni@lshtm.ac.uk
Tel: +44 (0)20 7927 2644
LSE Office of Development
and Alumni Relations
www.lse.ac.uk/alumni/
Email: alumni@lse.ac.uk
Tel: +44 (0)20 7955 7361
LSHTM Registry
50 Bedford Square
London WC1B 3DP
Email: registry@lshtm.ac.uk
Tel: +44 (0)20 7299 4646
Fax: +44 (0)20 7323 0638
LSE Graduate Admissions
Tower 2, Houghton Street
London WC2A 2AE
See website for online
enquiries (www.lse.ac.uk)
Tel: +44 (0)20 7955 7160
Fax: +44 (0)20 7955 6137

Design: LSE Design Unit

www.lse.ac.uk/designunit

Photography: LSHTM and LSE

The London School of Economics and Political Science and the

London School of Hygiene & Tropical Medicine are part of the
University of London. LSE is a charity and is incorporated in England
as a company limited by guarantee under the Companies Acts
(Reg No 70527).

The Schools seeks to ensure that people are treated equitably,

regardless of age, disability, race, nationality, ethnic or national
origin, gender, religion, sexual orientation or personal circumstances.

Every effort has been made to ensure that the information contained
herein is accurate at the time of going to print (June 2006), excludes
errors of fact and avoids ambiguity or overstatement, but the text is
issued errors and omissions excepted. No part of this document forms
part of any contract with any person and the Schools and shall not be
read or taken as such.

This information can be made available

in alternative formats, on request. Please
contact: mschppf@lshtm.ac.uk