Thanks! The four project ideas are mine but all the aspects that they cover are from the collection, reported as cost-saving or highly cost-effective. For example, clinic consultancy is not mentioned but hepatitis B (>$13.22/QALY, vol. 3, p. 158) or tetanus toxoid ($3.61/DALY, vol. 8., p. 424) vaccines are. These are examples of the figures from 1-9, which I am not citing for each aspect due to concision. I am hypothesizing that joining them can increase the cost-effectiveness by decreasing the marginal cost of each aspect.
If such consultancies exist in the developed and developing countries, then either they are profitable or useful. Joining and supporting them can be an opportunity and the organization does not need to be developed from scratch. Cultural accessibility could be something that can be either already present, e. g. at the Red Cross or called for in a grant application.
The social media health products would be profitable to social media platforms. Large proportion of Open Philanthropy recommendations are for Good Ventures, a philanthropic foundation of Dustin Moskovitz and Cari Tuna. Dustin Moskovitz owns a share in Facebook (responsible for much of the wealth in EA). Thus, advertisement on Facebook could be, in turn, profitable to this foundation.
I almost entirely deferred to experts on the DALY figures. This example suggests that in this case, the $/DALY was not an overestimate for a subset of countries and that cost-saving treatment is possible in specific contexts. I estimated that the benefit-cost ratio of over 70 is comparable to <$20/DALY. (A Brazilian vector control program for the Chagas disease “cost US$57 per DALY averted or saved US$25 for every dollar spent on prevention” (vol. 5, p. 204). 25/20*54=67.5). I believe that this is because the benefit accrues to the country as a whole, in healthcare savings, productivity, etc, while it is assumed to be paid by a sole donor.
If loans are offered to the government (who would run efficient programs in cost-effectiveness priority settings), then this seems like a great opportunity to the funders. From glancing at major development banks websites, targeting cost-effective healthcare opportunities is not emphasized in their agenda, while infrastructural and regulatory investment is. So, my thought is that finding a loan provider, suggesting cost-saving healthcare opportunities and assisting the government with effective spending of these loans can best address these opportunities, if they are yet uncovered.
Possibly, this has not yet been acted upon due to the overall reluctance of prevention, if this is relates to lifestyle. In this example, hypertension could relate to unhealthy diet and limited exercise. People may hesitate to be screened since that could suggest a lifestyle change. Some decisionmakers may reflect the public attitudes, so changes are relatively slow. Lobbies can be another reason. For example, tobacco lobby spending can prevent taxation or regulation of tobacco products. Fear of deeper issue uncovering could be a third, more rare, cause. For example, paying vineyard workers in alcohol in South Africa has been banned but screening could suggest that this is being done, even if the hypertension cause is unrelated.
I think that CHW recommendations should be generally more direct—it can be assumed that government is interested in pro bono upskilling of the workers and does not need to be extensively lobbied to share a training resource (e. g. online), unless they would have to pay for the training. Practices that are locally useful should be suggested to both government and NGO employees. I think that the easiest would be to develop some online training courses that have some shared core and ‘specializations’ for different settings (rural, urban, by different community characteristic). Employees would not need to study for what they already know and would learn what they are missing.
There is the question whether to take into account the drug production cost or the price paid by the patient/healthcare provider, if that is subsidized or free. Then, the cost-effectiveness can easily vary by an order of 10 or more.
Unless otherwise specified (e. g. providing artesunate rather than quinine for severe malaria), the cost-effectiveness of is in comparison to non-intervention, which is assumed as the current practice (or was in some of the studies). The volumes have been written in 2015-2017, so an updated understanding on what has improved and is remaining can be valuable. My guess is that about 80% of the need is still unmet, except for infectious diseases, where maybe 40% can be already covered, due to pharmaceutical company commitments and large philanthropy, such as the Bill and Melinda Gates Foundation, funding.
Thanks! The four project ideas are mine but all the aspects that they cover are from the collection, reported as cost-saving or highly cost-effective. For example, clinic consultancy is not mentioned but hepatitis B (>$13.22/QALY, vol. 3, p. 158) or tetanus toxoid ($3.61/DALY, vol. 8., p. 424) vaccines are. These are examples of the figures from 1-9, which I am not citing for each aspect due to concision. I am hypothesizing that joining them can increase the cost-effectiveness by decreasing the marginal cost of each aspect.
If such consultancies exist in the developed and developing countries, then either they are profitable or useful. Joining and supporting them can be an opportunity and the organization does not need to be developed from scratch. Cultural accessibility could be something that can be either already present, e. g. at the Red Cross or called for in a grant application.
The social media health products would be profitable to social media platforms. Large proportion of Open Philanthropy recommendations are for Good Ventures, a philanthropic foundation of Dustin Moskovitz and Cari Tuna. Dustin Moskovitz owns a share in Facebook (responsible for much of the wealth in EA). Thus, advertisement on Facebook could be, in turn, profitable to this foundation.
I almost entirely deferred to experts on the DALY figures. This example suggests that in this case, the $/DALY was not an overestimate for a subset of countries and that cost-saving treatment is possible in specific contexts. I estimated that the benefit-cost ratio of over 70 is comparable to <$20/DALY. (A Brazilian vector control program for the Chagas disease “cost US$57 per DALY averted or saved US$25 for every dollar spent on prevention” (vol. 5, p. 204). 25/20*54=67.5). I believe that this is because the benefit accrues to the country as a whole, in healthcare savings, productivity, etc, while it is assumed to be paid by a sole donor.
If loans are offered to the government (who would run efficient programs in cost-effectiveness priority settings), then this seems like a great opportunity to the funders. From glancing at major development banks websites, targeting cost-effective healthcare opportunities is not emphasized in their agenda, while infrastructural and regulatory investment is. So, my thought is that finding a loan provider, suggesting cost-saving healthcare opportunities and assisting the government with effective spending of these loans can best address these opportunities, if they are yet uncovered.
Possibly, this has not yet been acted upon due to the overall reluctance of prevention, if this is relates to lifestyle. In this example, hypertension could relate to unhealthy diet and limited exercise. People may hesitate to be screened since that could suggest a lifestyle change. Some decisionmakers may reflect the public attitudes, so changes are relatively slow. Lobbies can be another reason. For example, tobacco lobby spending can prevent taxation or regulation of tobacco products. Fear of deeper issue uncovering could be a third, more rare, cause. For example, paying vineyard workers in alcohol in South Africa has been banned but screening could suggest that this is being done, even if the hypertension cause is unrelated.
I think that CHW recommendations should be generally more direct—it can be assumed that government is interested in pro bono upskilling of the workers and does not need to be extensively lobbied to share a training resource (e. g. online), unless they would have to pay for the training. Practices that are locally useful should be suggested to both government and NGO employees. I think that the easiest would be to develop some online training courses that have some shared core and ‘specializations’ for different settings (rural, urban, by different community characteristic). Employees would not need to study for what they already know and would learn what they are missing.
There is the question whether to take into account the drug production cost or the price paid by the patient/healthcare provider, if that is subsidized or free. Then, the cost-effectiveness can easily vary by an order of 10 or more.
Unless otherwise specified (e. g. providing artesunate rather than quinine for severe malaria), the cost-effectiveness of is in comparison to non-intervention, which is assumed as the current practice (or was in some of the studies). The volumes have been written in 2015-2017, so an updated understanding on what has improved and is remaining can be valuable. My guess is that about 80% of the need is still unmet, except for infectious diseases, where maybe 40% can be already covered, due to pharmaceutical company commitments and large philanthropy, such as the Bill and Melinda Gates Foundation, funding.