Monday, August 6, 2012

[EQ] Infectious Disease, Injury and Reproductive Health

Copenhagen Consensus 2012 Challenge Paper

Infectious Disease, Injury and Reproductive Health

Dean T. Jamison 2; Prabhat Jha 3; Ramanan Laxminarayan 4; Toby Ord 5

This paper was prepared with partial support from the Disease Control Priorities Network Project funded by the Bill & Melinda Gates Foundation.
2 Department of Global Health, University of Washington, Seattle.

3 Canada Research Chair of Health and Development, Centre for Global Health Research, St. Michael’s Hospital and University of Toronto, Canada

4 Public Health Foundation of India, Delhi.

5 Department of Philosophy, University of Oxford.

Available online PDF [94p.] at:

This paper identifies key priorities for the control of infectious disease, injury and reproductive problems for the Copenhagen Consensus 2012 (CC12). It draws directly upon the disease control paper (Jamison, Bloom and Jha, 2008) from Copenhagen Consensus 2008 and the AIDS vaccine paper for the Copenhagen Consensus Rethink HIV project (Hecht and Jamison, 2011). This paper updates the evidence and adjusts the conclusions of the previous work in light of subsequent research and experience. For CC12 noncommunicable diseases are being treated in a separate paper (Jha, Nugent, Verguet, Bloom and Hum, 2012) that complements this one.

All these papers build on the results of the Disease Control Priorities Project (DCPP).6 The DCPP engaged over 350 authors and estimated the cost-effectiveness of 315 interventions. These estimates vary a good deal in their thoroughness and in the extent to which they provide regionally-specific estimates of both cost and effectiveness. Taken as a whole, however, they represent a comprehensive canvas of disease control opportunities.7 We will combine this body of knowledge with the results from research and operational experience in the subsequent four years.

The DCPP concluded that some interventions are clearly low priority. Others are worth doing but either address only a relatively small proportion of disease burden or simply prove less attractive than a few key interventions. This paper identifies 6 key interventions in terms of their cost-effectiveness, the size of the disease burden they address, the amount of financial protection they provide, their feasibility of implementation and their relevance for development assistance budgets. The resulting ‘dashboard’ of indicators underpins overall judgments of priority.

Separate but related papers for Copenhagen Consensus 2012 Challenge Papers CC12 deal with:

- Malnutrition (Hoddinott et al, 2012) with

- Water and sanitation (Rijsberman and Zwane, 2012)  with

- Population growth (Kohler, 2012)   and

- Education (Orazem, 2012) .


Before turning to the substance of the paper it is worth briefly stating our perspectives on the roles of the state and of international development assistance in financing health interventions. There are major positive externalities associated with control of many infections and there are important public goods aspects to health education and R&D. On one view the rationale for state finance is to address these market failures and to address needs of vulnerable groups. Our view is rather different…..”



1. Progress and Challenges

1.1 Progress

1.2 Remaining challenges

2. The Economic Benefits of Better Health

2.1 Health and income

2.2 Health and economic welfare

3. Cost-Benefit Methodology

3.1 Cost-effectiveness analysis broadly and narrowly construed

3.2 Defining and redefining DALYs

3.3 The value of a DALY

3.4 The cost of a DALY

4. Child and Reproductive Health

4.1 Under-5 health problems and intervention priorities

4.2 Worm infections in school-age children

4.3 Delivering reproductive and child health interventions


5.1 Prevention of HIV transmission

5.2 AIDS vaccine development

5.3 Antiretroviral treatment of AIDS

6. Control of Tuberculosis

7. Opportunities for Disease Control

Appendix A: Sensitivity Analysis




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