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Conveying Information

In each and every case, information was used to raise awareness, to shape design, and/or to motivate. In China, for example, research showed that iodine deficiency posed a threat to children’s mental capacity. Raising awareness about the health problem focused political and technical attention on it and prompted government action.

© Pan American Health Organization / A. WaakIn Egypt, information from community trials and market research revealed consumer preferences that were essential for the design of a national oral rehydration program. Because the program depended in large measure on effective communication with mothers, it was important to gather information in the early stages to shape its design. Finally, in the guinea worm eradication campaign, information was disseminated in monthly publications that highlighted progress in different countries. Sharing this information motivated the countries involved in the campaign and kept pressure on those lagging behind.

Involving Communities

In some of the cases profiled, the communities whose health was affected by a disease played a strong and active role in its eradication. Tens of thousands of communities across Central and East Asia, for example, organized and managed the local distribution of ivermectin—the antibiotic that treats river blindness.

Because the affected communities assumed full responsibility for distribution of the drug, it increased the long-term sustainability of the program. “Village volunteers”—who were selected by the community and trained by NGOs—also served on the front line in the guinea worm campaign by distributing fliers, raising public awareness, and identifying and containing cases.

Predicting funding

It doesn’t necessarily take vast sums of money to make public health work because cost-effective interventions can be employed. What is needed, however, is steady funding to ensure that the programs can be sustained for a long enough period of time to have a major impact.

In many of the cases we researched, a large share of the funding came from external donors. Some $560 million was invested over 30 years by many donors to virtually halt the transmission of river blindness in 20 West African countries; a $26 million grant from USAID to Egypt helped the country prevent 300,000 child deaths from diarrheal disease; and, $88 million came from an extensive list of donors and NGOs to cut the number of people affected by debilitating ailments caused by guinea worm from 3.5 million to just 35,000.

The payoffs are huge. Eradicating smallpox from the globe cost the donor community less than $100 million. The U.S., the campaign’s largest donor, saves its total contribution every 26 days because vaccination is no longer required. The economic benefits of controlling river blindness were seen in improved agricultural productivity and other poverty-reducing outcomes. One analysis estimated that each dollar spent on the program generated $1.17 in economic benefits. The Human Payoff

Beyond the economic reasons for caring about health are the human ones. In light of the cases we studied, it is impossible to argue that little can be done

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to close the health gap between rich and poor. It will certainly not be easy, or fast, or without significant technical, operational, and political challenges. But, as these experiences demonstrate, the potential exists to change the course of human history for the better through effective public health programs in developing countries.

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