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.

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.

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.

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.

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.

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."

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.