A few billion dollars. Not a lot of money when you consider that's all it would take to save millions of lives a year and boost national incomes by several digits. How? Health care is how.
According to a major new study looking at the costs and benefits of health interventions in the world's poorest countries, health care investments bring the sort of returns Wall Street dreams about. Prepared by a prominent group of 25 health experts and economists, the Global Health 2035 report says that narrowing the gap between the least healthy countries and middle-ranking countries, such as Chile and China, could deliver nine to 20 times the original amount invested. By 2035, up to 10 million people who currently die prematurely could be saved.
The report calls for funding in three main areas. First, in reducing the rates of infectious disease and mortality in infants, children, and their mothers, particularly in rural regions. Second, in reducing the risks from non-communicable diseases, particularly from smoking, alcohol, sedentary behavior, and traffic accidents (the leading cause of death among people age 15 to 29). And third, in managing the cost to health care systems from the first two areas.
The study says reducing deaths at birth ought to be relatively straightforward, given modern science and resources. "A unique characteristic of our generation is that collectively we have the financial and the ever-improving technical capacity to reduce infectious, child, and maternal mortality rates to low levels universally by 2035, to achieve a 'grand convergence' in health," it says.
For the second area of non-communicable diseases, the authors suggest higher taxes on tobacco, alcohol, and sugary foods, eliminating subsidies on fossil fuels, and "regulating" transport to prevent high injury rates. The report also calls for cheap drugs to prevent common conditions like cardiovascular disease.
Finally, the commission looks at ways of expanding health care coverage, improving levels of pre-payment for services and increasing levels of prevention (which is cheaper than dealing with disease itself).
At the moment, investment is nowhere near the level required and most spending in misdirected from the developing world's point of view. Health R&D totaled $248 billion in 2009, but only $3 billion of that went to infectious diseases, or 1% to 2%. About 60% of the total came from the private sector, which concentrates on areas of the greatest private gain, like cancer.
Still the authors strike a hopeful tone, pointing to the wider benefits of health care spending to the public. "Good reasons exist to be optimistic about seeing the global health landscape utterly transformed in this way within our lifetimes," it says.