Close to 6 million children under the age of five died in 2015 of easily preventable or treatable diseases. Three hundred thousand women die from conditions related to pregnancy, most of which are similarly within our power to treat. More than half of these, along with huge numbers of still births, could be eliminated for a cost of less than $5 per beneficiary per year, according to a paper in The Lancet.
Professor Robert Black of Johns Hopkins University presented the findings at the Consortium of Universities for Global Health conference held over the weekend. “Many of these deaths could be prevented if high-impact and affordable solutions reached the populations that needed them most," Black said in a statement. "Our analysis shows that expanding access to care to keep more mothers and children alive and healthy is feasible and a highly cost-effective investment."
Black and his colleagues considered the benefits offered by 66 demonstrably effective interventions that are still unavailable across wide swathes of the planet. Examples include antibiotics, nutrient supplementation during pregnancy, and immunization against diseases like hepatitis. Acknowledging that getting treatments into war zones will be almost impossible, their estimates are based on achieving access for 90 percent of target populations. “Particularly effective interventions in the Maternal and Newborn Health and Child Health packages would be management of labor and delivery, care of preterm births, and treatment of serious infectious diseases and acute malnutrition,” the paper notes.
The annual price of such a world-changing project would be $26.6 billion dollars – an apparently enormous figure that represents just $4.70 per person living in the low and middle income countries, totaling 5.5 billion people, where the interventions are required.
"Community health workers or primary health centers can deliver the majority of these services, which reduces the cost of expanding coverage,” said Black. A quarter of the money is required by the low income countries most likely to need external support to pay for it.
Cost is not the only obstacle to creating change, however. Provision of contraceptives to everyone who wants them is among the most cost effective interventions, but often blocked by religious and cultural beliefs. The cost of these obstructions is vast. The paper notes: “In 2015, 12 percent of married or in-union women wanted to delay or avoid pregnancy but were not using any method of contraception... In developing countries, an estimated 74 million unintended pregnancies occurred in 2012.”
The unmet demand for contraception is so large that meeting 90 percent of it would prevent the deaths of 67,000 mothers and 913,000 children under five, almost half of them newborns.
Moreover, Black noted, "The benefits of scaling up these interventions extend well beyond health. For example, improving care at the time of birth gives a quadruple return on investment by saving mothers' and children's lives and preventing stillbirths and disability, while investing in nutrition can help children reach their potential in cognitive development." The paper estimates overall financial benefits are 8.7 times the costs.
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