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Prioritarianism is an ethical theory that gives extra weight to the well-being of the worse off. In contrast, dominant policy-evaluation methodologies, such as benefit-cost analysis, cost-effectiveness analysis, and utilitarianism, ignore or downplay issues of fair distribution. Based on a research group founded by the editors, this important book is the first to show how prioritarianism can be used to assess governmental policies and evaluate societal conditions. This book uses prioritarianism as a methodology to evaluate governmental policy across a variety of policy domains: taxation, health policy, risk regulation, education, climate policy, and the COVID-19 pandemic. It is also the first to demonstrate how prioritarianism improves on GDP as an indicator of a society's progress over time. Edited by two senior figures in the field with contributions from some of the world's leading economists, this volume bridges the gap from the theory of prioritarianism to its practical application.
Of every thousand children born in Iceland, two will die before
their first birthday, but in Mozambique the death rate is sixty
times higher. Even within countries - including some of the
wealthiest - inequalities in longevity and health can be
substantial. In recent years, epidemiologists have documented the
extent of these inequalities both between and within countries,
stimulating in turn research both on their sources and on possible
means for their alleviation. These extensive and influential
efforts in research and in policy development have raised health
inequalities to a prominent position among the central concerns of
both national and global health.
Global health is at a crossroads. The 2030 Agenda for Sustainable Development has come with ambitious targets for health and health services worldwide. To reach these targets, many more billions of dollars need to be spent on health. However, development assistance for health has plateaued and domestic funding on health in most countries is growing at rates too low to close the financing gap. National and international decision-makers face tough choices about how scarce health care resources should be spent. Should additional funds be spent on primary prevention of stroke, treating childhood cancer, or expanding treatment for HIV/AIDS? Should health coverage decisions take into account the effects of illness on productivity, household finances, and children's educational attainment, or just focus on health outcomes? Does age matter for priority setting or should it be ignored? Are health gains far in the future less important than gains in the present? Should higher priority be given to people who are sicker or poorer? Global Health Priority-Setting provides a framework for how to think about evidence-based priority-setting in health. Over 18 chapters, ethicists, philosophers, economists, policy-makers, and clinicians from around the world assess the state of current practice in national and global priority setting, describe new tools and methodologies to address establishing global health priorities, and tackle the most important ethical questions that decision-makers must consider in allocating health resources.
Distributional cost-effectiveness analysis aims to help health care and public health organisations make fairer decisions with better outcomes. Whereas standard cost-effectiveness analysis provides information about total costs and effects, distributional cost-effectiveness analysis provides additional information about fairness in the distribution of costs and effects - who gains, who loses, and by how much. It can also provide information about the trade-offs that sometimes occur between efficiency objectives, such as improving total health, and equity objectives, such as reducing unfair inequality in health. This is a practical guide to a flexible suite of economic methods for quantifying the equity consequences of health programmes in high-, middle- and low-income countries. The methods can be tailored and combined in various ways to provide useful information to different decision-makers in different countries with different distributional equity concerns. The handbook is primarily aimed at postgraduate students and analysts specialising in cost-effectiveness analysis but is also accessible to a broader audience of health sector academics, practitioners, managers, policymakers and stakeholders. As well as offering an overview for research commissioners, users, and producers, the book includes systematic technical guidance on how to simulate and evaluate distributions, with accompanying hands-on spreadsheet training exercises, and discussions about how to handle uncertainty about facts and disagreement about values, and the future challenges facing this young and rapidly evolving field of study.
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