Life is Cheap

The WHO has declared swine flu a pandemic and the US is considering a vaccination program involving 600 million doses. 

So far, the CDC estimates that there have been a million infections and 127 deaths in the US.  That’s a pretty low death rate, of around one per ten thousand.  The US rate for measles in the 1970s was almost ten times as high.  In turn, that suggests a comparatively low benefit-cost ratio compared to other vaccine programs.

The good news is that even more expensive vaccine programs are amongst the most cost effective health interventions.  The flu vaccine only costs between $5-9 a dose, for example.  And they are comparatively easy to roll out.  Not least, thanks to vaccinations sold at a dollar a pop, almost no one gets measles in the US any more.  In the first half of this year, there were only 25 cases in the whole country. 

The even better news is that, thanks to expanded vaccination coverage, dramatically fewer people die of measles the world over.  Measles deaths in Africa fell by 91% between 2000 and 2006 alone, from an estimated 396,000 to 36,000.  Keep on going at this rate, and measles might be the next smallpox. 

Other simple health solutions that have saved millions include hand-washing and antibiotics.  Their spread lies behind a dramatic global convergence in health outcomes discussed in this book I’m plugging.  And there’s still scope for cheap solutions to make a big difference to global health outcomes.  One third of the remaining ten million child deaths each year could be prevented if parents worldwide breast fed, used sugar-salt solutions to treat cases of diarrhea and put their children to sleep under insecticide-treated bed nets.  Breast feeding is free, sugar-salt packages cost pennies, and bednets perhaps $5. 

The big problem now is to create demand –informed parents who understand what to do when their child has diarrhea, for example.  In the Indian state of West Bengal, fifty percent of parents think you should give a child less to drink –absolutely the wrong thing to do.  Child mortality in the state is three times higher than in the state of Kerala, where only five percent of parents suggest that response.   And not all parents understand the importance of a vaccination program, especially when their state governors are telling them it is part of a plot to sterilize their children, as it might be –this particular piece of insanity helped delay the global eradication of polio. 

Of course, as the recent flap over MMR in the UK demonstrates, the demand side isn’t just a Third World problem.  Let’s hope we don’t face the same issues with swine flu vaccination.

One thought on “Life is Cheap

  1. In turn, that suggests a comparatively low benefit-cost ratio compared to other vaccine programs.

    As I understood it the main goal isn’t so much death prevention (percentage of infected people that die from swine flu is very low), but to minimize the economic impact of so many people ill in bed.

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