Below is our basic outline for identifying the best options for donors within developing-world health. (Economic empowerment and possibly other developing-world causes will come after we have completed our report on direct health interventions.)
Focus on two priority regions and several priority interventions
As this post explains, we are simultaneously taking two approaches: a region-based approach (studying a particular region in depth, and aiming to fund interventions targeted to the specific needs of the region) and a program-based approach (identifying particularly promising interventions and funding their scale-up throughout the world).
Priority interventions: focus on the most proven, scalable, and cost-effective
Our general criteria for selecting program-based interventions are discussed here. To start, we are prioritizing what we call straightforward interventions, or interventions that can be carried out infrequently and for which the burden of monitoring and evaluation is relatively low. As discussed here, these interventions are also rated among the most cost-effective interventions by existing studies of cost-effectiveness. They are:
- Vitamin supplementation programs, providing nutrients such as vitamin A (which reduces the risks of infant mortality, development of blindness, and deaths in childbirth – reference here).
- Mass drug administration programs, particularly those aiming to treat school-age children who suffer from intestinal parasites. (Such interventions have been shown to improve school attendance and likely nutritional status.)
- Vaccination campaigns to cost-effectively save lives.
- Vitamin fortification programs such as the iodization of salt.
- Surgical programs to correct deformities such as cleft palate and fistula.
We may add other priority interventions, particularly if we see particularly strong donor demand for interventions with fundamentally different goals.
Priority regions: help those in great need and those with great potential
Our region-based research will be less focused on strict definitions of “cost-effectiveness” and more on finding programs that address a region’s needs broadly and holistically, somewhat along the lines of Partners in Health (and more in line with the vision of the WHO commission on macroeconomics and health than that of the Copenhagen Consensus). The first step will be picking two priority regions.
Priority region 1: one priority region will reflect a goal of helping those in the most need. We are currently in the process of identifying countries that have both high and drastic disease burdens and relatively stable, low-corruption environments in which aid can likely be productive. Preliminarily, our strongest candidates are:
- Burkina Faso
The process for identifying these six countries is detailed here.
Priority region 2: the other priority region will reflect more of a triage approach: identifying an area where health conditions are poor and help is needed but strong economic opportunities exist for those at a reasonable level of personal health and productivity. Preliminarily, we are guessing that our work in this area will likely focus on somewhere in India, but we have not yet completed this analysis.