OneWorld.net (U.S.)

“Assuring that cost-effective interventions to address the major burdens of disease are delivered and available to everyone is the only way to close the health gap between the haves and the have nots.” Disease Control Priorities Project

Keeping people healthy is a complicated task, involving good nutrition, distribution of medicine, the availability of health facilities and qualified practitioners, scientific research, education, vigilance, and much, much more. It’s no surprise that in poorer communities and less developed countries—where resources for healthcare may be lacking—death and disease rates are usually higher and quality of life significantly lower.

© Pan American Health OrganizationBut as healthcare interventions have become more effective and technological innovations have brought the world closer together, many have argued that the poor should no longer have to suffer the burdens of disease and other health conditions to the extent that they still do. This is particularly true when a variety of preventive measures exist that are relatively low-cost and which, if implemented, could help ensure that people do not get sick in the first place—and need more expensive treatments as a result. As most working in the field will attest, a penny of prevention is still worth a pound of cure.

Cost-Effective Proposals

Widely considered to be one of the most cost-effective measures in public health, childhood immunizations can offer a lifetime of immunity from certain diseases. According to the World Bank, it costs $17, on average, for a child to be fully immunized against six common diseases, including tetanus, polio, and measles. While considered a “best buy” in most cases, these costs may still be prohibitive for countries like Ethiopia, whose health budget is only $3 per capita per year. In these situations, international financial assistance may be necessary to ensure expanded vaccination programs—one reason that the Global Alliance for Vaccines and Immunizations (GAVI) was launched in 2000. This alliance of public and private partners has raised over $6 billion—including a new international financing facility—to develop and deliver immunization programs in developing countries. GAVI claims that its programs have already led to the vaccination of some 100 million children.

A more grassroots approach to child survival was seen in Nepal, where nutritional deficiencies remained a major public health problem in the 1980s. Community leaders moved into action and mobilized an army of volunteers to get needed Vitamin A capsules to some three million children in 93 districts. Launched in 1993, the effort included training women volunteers and organizing rallies and was later praised by the World Bank as one of the most cost-effective health interventions of all time.

While initiatives like these are heartening, the fact remains that needs outstrip health resources almost everywhere—and particularly so in developing countries. So how is a policy maker to decide where to put limited funds? Some 500 scientists, economists, and health practitioners tried to answer this question by launching three new reports in April 2006 that looked at a range of options for poor nations. With over 40 consultations involving developing-country participants, the Disease Control Priorities Project (DCPP) provides a comprehensive survey of global health and recommends a number of cost-effective interventions for low- and middle-income countries.

Among preventive steps recommended are: the use of insecticide-treated bed nets in malaria-endemic zones; vaccinating children against major childhood diseases; teaching family members to promote basic hygiene to reduce diarrhea in children and treat it with oral rehydration therapy; promoting 100-percent condom use and education to populations most at risk of contracting HIV/AIDS; increasing taxes on tobacco products to reduce the prevalence of cancer, cardiovascular, and respiratory diseases; and regulating salt and saturated fat in manufactured foods.

The UN’s Millennium Project has also recommended a range of “Quick Wins” to achieve the Millennium Development Goals—a set of targets identified by the international community to substantially reduce poverty and improve public health by 2015. Health-related recommendations include providing regular de-worming treatments to all schoolchildren in affected areas, providing micronutrient supplements (especially Vitamin A and Zinc) to pregnant and lactating women and children under five, expanding access to sexual and reproductive health information, and eliminating user fees for basic health services in all developing countries.

The list of simple interventions goes on and on. A PBS series that aired in late 2005 titled “Rx for Survival” implicated unclean water and malnutrition as important risk factors for 80 percent of childhood deaths. The International Food Policy Research Institute adds that more than one-third of the population in sub-Saharan Africa have diets deficient in essential vitamins and minerals, which can be the cause of illness or premature death. IFPRI is thus working with African health and agricultural leaders to harness technology to breed staple crops that include more essential nutrients.

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