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The book examines applications in two disparate fields linked by
the importance of valuing information: public health and space.
Researchers in the health field have developed some of the most
innovative methodologies for valuing information, used to help
determine, for example, the value of diagnostics in informing
patient treatment decisions. In the field of space, recent
applications of value-of-information methods are critical for
informing decisions on investment in satellites that collect data
about air quality, fresh water supplies, climate and other natural
and environmental resources affecting global health and quality of
life.
Our ability to treat common bacterial infections with antibiotics
goes back only 65 years. However, the authors of this report make
it clear that sustaining a supply of effective and affordable
antibiotics cannot be without changes to the incentives facing
patients, physicians, hospitals, insurers, and pharmaceutical
manufacturers. In fact, increasing resistance to these drugs is
already exacting a terrible price. Every day in the United States,
approximately 172 men, women, and children die from infections
caused by antibiotic-resistant bacteria in hospitals alone. Beyond
those deaths, antibiotic resistance is costing billions of dollars
through prolonged hospital stays and the need for doctors to resort
to ever more costly drugs to use as substitute treatments.
Extending the Cure presents the problem of antibiotic resistance as
a conflict between individual decision makers and their short-term
interest and the interest of society as a whole, in both present
and future: The effort that doctors make to please each patient by
prescribing a drug when it might not be properly indicated, poor
monitoring of discharged patients to ensure that they do not
transmit drug-resistant pathogens to other persons, excesses in the
marketing of new antibiotics, and the broad overuse of antibiotics
all contribute to the development and spread of
antibiotic-resistant bacteria. The book explores a range of policy
options that would encourage patients, health care providers, and
managed care organizations to serve as more responsible stewards of
existing antibiotics as well as proposals that would give
pharmaceutical firms greater incentives to develop new antibiotics
and avoid overselling. If the problem continues unaddressed,
antibiotic resistance has the potential to derail the health care
system and return us to a world where people of all ages routinely
die from simple infections. As a basis for future research and a
spur to a critically important dialogue, Extending the Cure is a
fundamental first step in addressing this public health crisis. The
Extending the Cure project is funded in part by the Robert Wood
Johnson Foundation through its Pioneer Portfolio.
The book examines applications in two disparate fields linked by
the importance of valuing information: public health and space.
Researchers in the health field have developed some of the most
innovative methodologies for valuing information, used to help
determine, for example, the value of diagnostics in informing
patient treatment decisions. In the field of space, recent
applications of value-of-information methods are critical for
informing decisions on investment in satellites that collect data
about air quality, fresh water supplies, climate and other natural
and environmental resources affecting global health and quality of
life.
At the turn of the millennium, the world experienced a dramatic
increase in funding for global health programs. Competing demands
for these resources meant that policymakers needed access to valid,
evidence-based information on the costs and consequences of a broad
range of health interventions. By providing systematic and
comparable information about purchasing health in LMICs, Disease
Control Priorities in Developing Countries, Second Edition greatly
informed and enriched these conversations and & we hope -
improved resource allocations. Nearly ten years later, increased
attention to chronic diseases and the importance of health systems
in providing access to quality care is once again reshaping the
global health landscape. Low- and middle-income countries are
continuing to set priorities for funding and deploying specific
interventions, but with a greater appreciation for the contribution
of program and economic evaluation to informed decision-making. The
need to make decisions across an increasingly complex set of policy
and intervention choices, attuned to specific health system
capabilities, makes a third iteration of Disease Control Priorities
all the more critical. Similar to the first and second editions of
Disease Control Priorities (DCP1 and DCP2), the aim of the third
edition (DCP3) is to influence program design and resource
allocation at global and country levels by providing an up-to-date
comprehensive review of the effectiveness of priority health
interventions. It presents systematic and comparable economic
evaluations of selected interventions, delivery platforms, and
policies based on newly developed economic methods. DCP3 further
expands on the scope of intervention assessments found in DCP1 and
DCP2 by presenting findings in nine individual volumes. It is clear
that optimal global health programming requires a comprehensive
evidence-base to help determine what works, what does not, how much
it will cost. DCP3 will allow users to set global and national
priorities for health in an informed manner.
As the culminating volume in the DCP3 series, Volume 9 will provide
an overview of DCP3 findings and methods, a summary of messages and
substantive lessons to be taken from DCP3, and a further discussion
of cross-cutting and synthesizing topics across the first eight
volumes. The introductory chapters (1-3) in this volume take as
their starting point the elements of the Essential Packages
presented in the overview chapters of each volume. First, the
chapter on intersectoral policy priorities for health includes
fiscal and intersectoral policies and assembles a subset of the
population policies and applies strict criteria for a low-income
setting in order to propose a "highest-priority" essential package.
Second, the chapter on packages of care and delivery platforms for
universal health coverage (UHC) includes health sector
interventions, primarily clinical and public health services, and
uses the same approach to propose a highest priority package of
interventions and policies that meet similar criteria, provides
cost estimates, and describes a pathway to UHC.
The increasing resistance of bacteria to antibiotics, and pests to
pesticides, threatens to undo some of the most remarkable advances
made in public health and agriculture during the past century.
Though the potential consequences of increased antibiotic and
pesticide resistance are far reaching, regulatory efforts to
address the problem are at a very early stage. Battling Resistance
to Antibiotics and Pesticides moves such discussions forward by
presenting cutting edge research and the first comprehensive
application of economic tools to analyze how antibiotics and
pesticides should be used to maximize their value to society.
Laxminarayan and his contributors explore lessons from past
experiences with resistance, especially in agriculture. They
consider what incentives would be ideal for the individuals who
prescribe or apply antibiotics and pesticides, and what would be
ideal for the firms engaged in developing and producing these
products. The chapters in this groundbreaking book reflect the fact
that efforts to combat resistance will require contributions from a
broad range of scholars and professionals, representing a broad
range of expertise. The analysis demonstrates that, for all these
participants, an understanding of economic issues is an essential
complement to knowledge of medical or biological factors. The book
provides economists with an overview of relevant scientific issues,
as well as a variety of analytical approaches to studying the
economics of resistance. It offers policymakers detailed analyses
of the multiple dimensions of resistance and discusses the future
strategies to combat and manage resistance. For professionals in
medicine, public health, and agriculture, the book translates the
economic approaches into usable guidance for daily practice and
decisionmaking.
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