Hi Svetha,
Thanks for accepting these questions and for the impressive work that New Incentives has achieved! I’d like to ask if you have any new data about the effect of the NI-ABAE program on overall health-care attendance behaviour of families—has the program generated any additional data about whether CCTs lead to families prioritizing the incentivized infant vaccine visits over other healthcare visits (including those for other family members) for which no incentive is paid? Or conversely, perhaps other healthcare visits might also increase for some reason? Thanks!
Hi Sjir—This is a great article and appropriately challenging for those who haven’t thought about this before. I agree with your summary message. I also agree that it’s a sensitive exercise to compare in this way, but choosing such a fundraising colossus to compare to makes it much more palatable, in my view.
With regard to the broader St Jude’s mission, you limit your research discussion to the impact of St Jude’s on advancing cancer treatment for children in the USA. However, St Jude’s is an international resource that runs a large global oncology program, including in LMICs. They work with a collaborative network of 400+ hospitals on capacity-building, education, their “Global Platform for Access to Childhood Cancer Medicines”, quality improvement tools, research, and policy work with WHO and national governments—thus potentially magnifying their impact significantly. This is important work with the rising importance of non-communicable diseases in LMICs. But like most global health programs run out of academic institutions in high income countries, the focus is not on cost effectiveness.
It’s unlikely that factoring these global activities into your calculations will fundamentally change the summary message. But it’s notable what might be achieved by convincing St Jude’s (and other academic health science centres in high income countries) to redirect some of its massive budget ($2.7B annually and rising rapidly) to its global programs in LMICs, and to focus on improving the cost effectiveness and marginal impact of those programs.