Tuesday, December 29, 2009

Back to blogging about health economics and infectious disease

Yesterday, while many of us in academia were "off" or working at a reduced level, the staff who prepare the Johns Hopkins Bloomberg School of Public Health news feed were still working hard.  One of the articles posted by the news feed yesterday was on drug resistant tuberculosis in the United States.  This is an important issue.

In one of the two classes I taught at the Johns Hopkins Bloomberg School of Public Health in the eight weeks between late October and mid-December, I had an entire lecture on the economics of infectious disease.  The issues raised by drug resistant TB are critical to understand.

First, they illustrate the importance of the economics of information.  There was a time at which the overall impression was that we had a handle on how to take care of infectious disease in general.  In the time since, we've seen the emergence of HIV and the emergence of an increasing number of drug resistant diseases in the time since then.

Second, the importance of the provision of public funding for certain things.  There are some markets that are difficult to make functional as private markets.  When individuals with limited resources are faced with something that doesn't  necessarily require immediate attention, they will use the resources they do have in favor of more immediate concerns.  Why?  The personal benefit does not outweigh the personal cost.  However, the social benefit may outweigh the social cost as others will benefit from individuals at risk of things like TB (and drug resistant TB in particular) taking care of themselves.  Sometimes, the only way to achieve this is through public funding.

Third, the importance of using resources for monitoring the use of drugs that are given as treatment.  When antibiotics are not used properly they can increase drug resistance. Thus, the proper use of antibiotics is a public good as ultimately everyone is at risk of being affected when drug resistant strains of disease causing organisms arise.

Some situations require regulation and coordination that only a government can provide.  Failing to regulate and coordinate can put many (some of whom understandably do not always see the need for their tax dollars to be used for 'public health') at risk.  

If you follow the link and read the article note one thing in particular: at the top of the second screen, it notes that drug resistant infection killed more people than all cases of breast and prostate cancer combined.  Think for a moment about which gets more attention in the news.  Think for a moment about which you may have been asked to make a donation for.  Then think about which one may be the biggest threat in the long run.  I don't have a definitive answer for the last question.  But it is quite possible that the answers to which you've heard about,  which you've been asked to make a donation for, and which is the biggest threat may not match up.

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