 |
||||
|
The Copenhagen Consensus, a group of eight eminent economists (including three Nobel Prize winners), has identified three of PSI's principal health areas as being "very good" uses of public funds, with benefits exceeding costs by a factor of ten or more: HIV/AIDS prevention, micronutrients and malaria control. Small-scale water technology for sanitation, another important PSI activity, was determined to be a "good" use of funds. The group considered a large number of development challenges and was asked to identify those that would be the most important to address given the limitation of financial resources. The panel rated four proposals as "very good," and three of them are among PSI's highest priorities: HIV/AIDS Prevention: The panel put measures to restrict the spread of HIV/AIDS at the top of the ranking. The London School of Hygiene and Tropical Medicine reckoned that a package of preventive measures costing some $27 billion over eight years should prevent nearly 30 million new infections, reducing expected infections from 45 to 17 million over the same period. One study calculated that part of this package, condom distribution combined with treatment for sex workers who are suffering from sexually-transmitted infections, would entail a cost of just $4 for each disability-adjusted life-year saved. The implied ratio of benefits to costs is nearly 500. The experts addressed the importance of targeting the general public, an issue that has become contentious in the debate over the best means of preventing HIV infection: "In countries with nascent epidemics, measures would clearly focus on preventive measures among high risk groups," writes Anne Mills and Shillcut of the London School in the summary of the Copenhagen Consenus Challenge Paper. "As a generalized epidemic develops, this package of measures must be implemented on a wider scale. Such interventions may have positive side effects in terms of reduced levels of other sexually transmitted diseases and overall better health education." Micronutrients: In second place, came a proposal to attack malnutrition
- particularly, iron-deficiency anemia and iodine, vitamin A and zinc
deficiencies - through targeted promotion of food supplements. The specific
modes of micronutrient delivery suggested are flour fortification, tablet
supplementation and vitamin A as an addition to immunization programs.
Again, the evidence suggests that it offers exceptionally high ratios
of benefits to costs. PSI has been doing micronutrient supplementation
since 1999 through the social marketing of multivitamins and iron-folic
supplements. However, we have not succeeded in exciting donor interest
and, therefore, micronutrient supplementation accounts for less than
1% of PSI's person years of protection (PYPs) in 2004. Small-Scale Water Technology: The panel put "Sanitation and Water" in sixth place as a "good" use of funds and identified small-scale water technology as an opportunity for addressing that challenge. Although nothing like PSI's safe water system is specifically recommended, the group did suggest "community-managed low-cost water supply and sanitation" as one of two principal opportunities in this area. The group does note, however, that a WHO study found that the cost-effectiveness improves significantly if chlorination at the point of use (à la PSI's safe water system) is added to intermediate solutions such as standpipes and latrines. The Copenhagen Consensus provides strong validation of PSI's chosen health interventions, and PSI staff should use these findings freely, both for proposal and public relations purposes. For more information, and all the papers and summaries relating to the recommended health interventions, go to <www.copenhagenconsenus.com>. — David J. Olson, PSI/Washington |
 |
|
|
|
|
||||
