Since 1994, the world has spent about $97.9 billion trying to develop new tools to fight infectious diseases in poor countries. These include vaccines, treatments, diagnostic tools and preventive equipment such as bed nets for diseases such as malaria.
It sounds like a lot of money, and it is. but Principles of Cure Research, the organization that came up with that number, also tried to estimate the benefits this research generated. They also got a dollar figure in there: $49.7 trillion. Full investment could avoid, the report found, about 40.7 million total deaths between 2000 and 2040.
These are big claims that deserve verification. But they hold on.
The discovery is particularly important at a time when important institutions such as the World Health Organization, the vaccine fund Gavi, and the Global Fund to Fight AIDS, Tuberculosis and Malaria Conducts all fundraising drives, which world leaders have yet to respond to with adequate investment. Resistance is understandable (they are large sums) but short-sighted.
Investing more in developing cures, treatments and vaccines for the world’s deadliest infectious diseases has enormous benefits. We just have to do it.
How did they determine how many lives were saved?
Research has focused on what Policy Cures calls “neglected diseases.” This means infectious diseases that primarily affect the developing world. Their burden is enormous. Respiratory infections and tuberculosis were responsible 153 million years of healthy life lost In 2019. This is almost double the number of people injured in car accidents worldwide.
The report found 183 new technologies targeting these diseases approved between 1999 and 2023. It hired an outside firm, Aveni Healthwhich uses data from Global Burden of Disease Study They are to model the extent of death and disease to date. In some cases, the authors also had to extrapolate. Some technologies, such as the RTS,S and R21 malaria vaccines, have only received World Health Organization support in the past few years, so the authors hypothesize that they will be beneficial if/when they become available.
In total, they estimate that these technologies will save 2.47 billion years of life (after adjusting for future lives saved). This is about 40.7 million total lives saved. It’s a great, fantastic total.
Putting a price tag on a human life
Calculating ROI for global health investments is difficult. First you need to know how much the investment costs. A total of $97.9 billion has been spent on this technology so far. Pushing through promising tools currently in the “pipeline” that could be launched before 2040 would cost another $24.8 billion, for a total cost of $122.7 billion.
Then, some judgment calls need to be made to place a dollar value on the benefits gained.
Much of the benefit comes from saving lives and preventing illness. To calculate an ROI number, you need to put a monetary value on those lives saved and illnesses prevented, a value you can compare to the upfront investment cost. The report estimates $19,985 saved per healthy life year. Multiply that by the 2.47 billion life years saved by these technologies and you get about $49.4 trillion.
Add their estimate of the general economic benefit to society because workers and dependents are less burdened by disease ($269.8 billion), and you get the reported total benefit of $49.7 trillion, or $405 for every dollar invested.
Even that ROI is arguably an undercount.
The figure of $19,985 per life year that drives 99 percent of these benefits is a variant of what is known as “statistical life value” and is one of the most complex and controversial tasks in computational economics.
Generally, value is estimated by measuring what individuals are willing to pay to reduce their risk of death. The idea is that people’s actual spending gives a truer idea of their feelings than, say, their voting. But people in poor countries are willing to pay less than people in rich countries, obviously because they have less money. This approach leads to the conclusion that life is literally precious in poor countries Less in fact, the Policy Cure report uses smaller values of statistical life expectancy for poorer countries.
In a subsection, they make assumptions where every life counts equally. Using the US ($12.3 million) value and applying it equally to every human being, they achieve an ROI of over $9,000 per dollar – which the report rejects as “potentially unrealistic and damaging to the project’s credibility”.
I think the $9,000 figure is more realistic. Setting a low standard makes some sense for the Nigerian government; The statistics give policymakers a sense of how much their citizens are willing to pay to save their lives, in situations where they would pay.
But governments in poor countries are not the main funders of malaria vaccine research. The funders are the governments and foundations of rich countries – in other words, the global North group Every life in these groups should be valued equally, and higher.
We must spend now to make these gains possible
The vast majority of these billions of life years have already been saved, but some are yet to come. The report estimates that malaria vaccines will save about 370 million life years between now and 2040. But malaria vaccines are rarely introduced The first vaccine, RTS,S, It took decades to be releasedAnd even now advocates are raising the alarm that We don’t have enough money to fund a full rollout For every child who needs a vaccine.
These vaccines could save 370 million life years, but they may not. We need to invest in getting them to those who need them.
This is a very promising report. But it’s a report that also serves as a call to arms. Rich countries must act quickly, or this opportunity will slip through our fingers, costing poor children in Africa and South Asia.
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