91av don’t come much tougher than this. Whoever is chosen as the new head of the World Health Organization has $4.5 billion a year to spend – but when you’re trying to improve public health on a planet of 7.5 billion people, you have to use it wisely.
So the new director-general needs to prioritise areas where a sharper focus would squeeze the most out of every dollar, yen, euro or pound spent. Doing this would also bolster the case for an increase in the WHO’s budget.
Considered this way, tuberculosis must be on the list. It has been overlooked and underfunded. Despite being the world’s biggest infectious killer, of development assistance for health in 2015, compared to 29.7 per cent for HIV and AIDS.
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Research for the Copenhagen Consensus Center, the think tank I set up that examines the best ways to maximise the impact of global health and welfare spending, shows that would be one of the most effective investments. This can be achieved through more active detection and diagnosis, and increased treatment.
Doing this would cost around $8 billion a year, but result in 1.3 million fewer deaths and bring benefits worth $43 for every dollar spent. Although the sum required outstrips the WHO’s budget, if it led on this, others would follow.
Significant gains would also come from stepping up immunisation initiatives. Copenhagen Consensus that for about $1 billion a year, vaccination programmes could be expanded, chiefly to widen protection against childhood pneumonia and diarrhoea, saving an additional 1 million lives annually. Each dollar spent on this would generate $60 worth of benefits.
Efforts to continue and step up the fight against malaria are also hugely worthwhile, with for every dollar spent.
Family healthcare
In addition, mother and infant healthcare merit prioritisation. In Bangladesh, for example, our work shows that for pregnant mothers and newborns should be a key focus, because the avoidance of stunting transforms a child’s entire life. In Haiti, backs the WHO’s focus on maternal and neonatal care: reaching 95 per cent access to healthcare for pregnant women would reduce the maternal mortality rate by 65 per cent.
Family planning also deserves more attention, with over 200 million women unable to get contraception. Near-universal access a year, but 150,000 fewer maternal deaths and 600,000 fewer children orphaned. And lowering birth rates can boost economic growth – the so-called demographic dividend. The benefits to society are worth 120 times the cost, making this a phenomenal investment that should be championed by liberals and conservatives alike.
Continued leadership on efforts to is also vital. Our shows that the annual cost of violence against women runs to $4.4 trillion, and that of assaults on children to $3.5 trillion.
And I’d like to see the new director-general focus even more on the planet’s biggest environmental health problem: indoor air pollution. More than 4 million people die every year from illnesses linked to inhaling noxious fumes while cooking on fires fuelled by wood, twigs and dung. We can fix this with and by getting grid electricity to more people.
None of these challenges will be the most newsworthy health story. But the role of the WHO and its new leader should be to look past headlines and the shifting trends of donors and the development industry, and instead shine a spotlight on the areas where every dollar has the greatest impact.
