The Economist on Ghana and on vaccines

This week’s Economist has a stupid article about vaccinations for diseases in poor countries. The print edition (page 67) says:

Amid the figures cited in Rome, one stood out. It was Ghana’s per capita health budget, calculated by the World Bank at $31 per day.

If only! Ghana’s public health budget is in fact $31 a person a year. Total public and private health expenditure in Ghana is just 27 cents a day.

It is striking to me that the journalist thought that $31 a day stood out – presumably as being a very low level – even though it is overstated by a multiple of 365. How much more does it stand out when we consider the real figure? It also just goes to show that even a journalist working on this story has no idea even what the correct order of magnitude is for health care expenditure in a developing country. (Update: the online edition has been nearly corrected, I see – though it should now say that this is the public health figure, which is about a third of the total spending on health).

That wasn’t the main reason the article was stupid, however. It peddles some half-baked criticisms of the scheme which could easily have been answered, if the journalist had bothered to do some homework.

So here are the answers which the journalist could have got if he or she had bothered to read any of the documentation:

Q. “Some sceptics have questioned whether this “jerry-rigging” of markets can work.”

A. You say “jerry rigging”, I say “correcting two market failures”.

Q. “This test … is skewed: a general vaccines for pneumococcal disease exists … and the only challenge is to tackle some extra strains”

A. The vaccine that exists protects against the strains common in America and Europe, but not the strains common in developing countries. The reason that there is no vaccine to protect against those strains is that the market for such a vaccine is not sufficiently large or certain. And the existing vaccine is not being produced for use in poor countries. Based on past experience of introducing new vaccines, such as Hib and Hepatitis B, there will be no vaccines in those countries before about 2023. So without an advance market commitment, there will be neither the development of an appropriate vaccine, nor will it be produced and sold in developing countries. And that means that more than 1.6 million children will continue to die every year from Streptococcus pneumoniae. So much for “the only challenge is to tackle some extra strains”.

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