International Decision Support Initiative (iDSI)

Strengthening and scaling countries' institutional capacities to make better decisions for health


The International Decision Support Initiative (iDSI) is a network of priority setting institutions that have, since 2013, supported the use of evidence in healthcare decision-making in low- and middle-income countries across the world.

LSHTM became an iDSI core partner in June 2021, leveraging its substantial existing expertise in cost-effectiveness analysis and global health. LSHTM also has extensive experience working with current and past iDSI partners including KEMRI-Wellcome in Kenya, and Thailand’s HITAP. The iDSI-LSHTM team is located within the Department of Global Health and Development.

iDSI responds to demand for government-to-government knowledge sharing to establish and sustain evidence-informed and procedurally fair mechanisms for better priority-setting in health. These include supporting the delivery of:

  • High quality Health Technology Assessments (HTAs) for a variety of interventional types
  • Supporting the use of other evidence-informed methods for priority-setting, including Clinical Guidelines and Quality Standards

iDSI’s mission emphasises the importance of developing capacity for robust technical analyses in the context of procedurally fair governance mechanisms in order to optimise resource allocation. It also stresses the need to develop adequate implementation strategies for any evidence informed outputs (e.g., linked changes to provider payment, education and regulation) to ensure impact of the priority setting process.

It aims to achieve this through:

(a) practical support (hands-on process support and institution strengthening)

(b) knowledge products (high quality, policy-relevant research) and

(c) fit-for-purpose capacity building and awareness raising.

iDSIplus (2018-2023) aims to build upon the achievements of iDSI by working with policymaker counterparts to embed evidence and good governance into domestic investment decisions at national and subnational levels in a number of countries including Kenya, Ghana, India and Rwanda.  

iDSIplus seeks to help countries to develop sustainable mechanisms for effective, evidence-informed priority-setting, and will involve mobilising a wide range of capacities among country stakeholders including the technical capacity to “do” research in economic evaluations.


Anna Vassall, Professor

Francis Ruiz, Senior Policy Fellow

Joseph Kazibwe, Assistant Technical Analyst

Sergio Torres Rueda, Research Fellow

Andres Madriz Montero, Research Assistant

Linda Amarfio, Project Coordinator

Rossana To, Project Administrator

Cassie Nemzoff, PhD student


Yang, L., Pearson, C. A. B., Montero, A. M., Torres-Rueda, S., Asfaw, E., Uzochukwu, B., Drake, T., BErgren, E., Eggo, R. M., Ruiz, F., Ndemi, N., Nonvignon, J., Jit, M. & Vassall, A. (2022). Assessing the impacts of timing on the health benefits, cost-effectiveness and relative affordability of COVID-19 vaccination programmes in 27 African Countries. Preprint:

Chi, Y. L., Blecher, M., Chalkidou, K., Culyer, A., Claxton, K., Edoka, I., Glassman, A., Kreif, N., Jones, I., Mirelman, A. J., Nadjib, M., Morton, A., Norheim, O. F., Ochalek, J., Prinja, S., Ruiz, F., Teerawattananon, Y., Vassall, A., & Winch, A. (2020). What next after GDP-based cost-effectiveness thresholds?. Gates open research4, 176.

Saadi, N., Chi, Y. L., Ghosh, S., Eggo, R. M., McCarthy, C. V., Quaife, M., Dawa, J., Jit, M., & Vassall, A. (2021). Models of COVID-19 vaccine prioritisation: a systematic literature search and narrative review. BMC medicine19(1), 318.

Hollingworth, S., Fenny, A. P., Yu, S. Y., Ruiz, F., & Chalkidou, K. (2021). Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis. Cost effectiveness and resource allocation : C/E19(1), 39.

Nemzoff, C., Ruiz, F., Chalkidou, K., Mehndiratta, A., Guinness, L., Cluzeau, F., & Shah, H. (2021). Adaptive health technology assessment to facilitate priority setting in low- and middle-income countries. BMJ global health6(4), e004549. 


Understanding the Cost-Effectiveness of COVID-19 Vaccination in Ethiopia

Understanding the Cost-Effectiveness of COVID-19 Vaccination in Nigeria


Price, Priorities, Pace: Three Factors that Drive Cost-Effectiveness of COVID-19 Vaccination Strategies in Kenya, Nigeria, and Ethiopia