The many ways of putting a price on life

 ‘Immunisation against pneumococcal disease, a leading killer of children in Africa, begins on Monday as a vaccine made by British company GSK is rolled out across Kenya. Thousands of lives will be saved. Sarah Boseley, in her article ‘Life-saving vaccine rolled out in Kenya’, ends the opening paragraph by asking ‘but could it have been done more cheaply?’ The vaccines, the article says are likely to save thousands of lives in Kenya, and beyond as Pneumonia is the cause of 18 percent of child deaths in developing countries.

The cost of paying for this vaccine apparently was US$2.8bn with the governments of Italy, the United Kingdom, Canada, Russia, and Norway and the Bill & Melinda Gates Foundation committed $1.5 billion and the Gavi Alliance promised to allocate $1.3 billion up to 2015. In order to provide other basic vaccines such as DTP, pneumococcal and rotavirus, the Gavi alliance will have to find an additional US$3.7 billion.

While reading Boseley’s article, I found myself continuously returning to her opening question ‘but could it have been done more cheaply?’ I think it resonated so strongly because recently I’d similar questions of another project which was concerned with reducing child mortality caused by diarrhea in sub-Saharan Africa. The project in question proposes a public-private partnership that will utilize existing private sector supply chains to get lifesaving products to the last mile. The pilot for the proposed project will cost US$1 million, which of course is no US$3.7 billion; it will impact between 2,000 to 10,000 mothers and will push US$33,000 worth of products through the supply chain. That’s right; a pilot that is all about supply chain effectiveness is going to cost US$1 million to push US$33,000 through an existing, well functioning supply chain.

One has to wonder how many more US$1 million dollar projects and pilots are out there that if approached differently, more frugally and effectively would result in greater impacts for less, and let’s not forget it’s not just healthcare economists that put a price on life. Every time an inefficient health care solution is rolled out anywhere, but particularly in a developing country, a price is put on life. Very simply, the less money there is to go round, the less healthcare solutions there are to go round, the more people pay with their lives. And that is a very high price for healthcare delivery inefficiencies. Surely, for those who claim to be at the forefront of providing healthcare for the poor, this is an unacceptable outcome and good reason to revolutionise or at the very least apply some of the principles of say frugal engineering to healthcare provision.