Howmuch funding is required to substantially reduce the global diseaseburden? And how many Giving What We Can members would we need tofinance the fight against diseases?

Oneof our pledgers has recently given a great TEDx talk on this topic:

Wehave collected some more figures of how much it would cost to fight some of the worst diseases and how many lives that would save below.

Malaria: US$ 7.83billion annually

Preliminaryestimations from a forthcoming WHO report[1] onMalaria suggest that, on average, $7.83 billion would have to be spentannually to reduce deaths and illness due to malaria by at least 90percent. The figure below shows how many malaria cases would be avertedand how many lives would be saved by this plan. Moreover, this planmight avert about 270 billion dollar 2030 in lost economic potential.

However,currently, only about 3 billion is spent on malaria (see figure below).
Figureadapted from[2]:Domestic and international investments increase in line with totalgovernment expenditure growth estimated by the IMF for 2014–2020 (notethat the figures and the target are based on estimations from 2008);GMAP = GlobalMalaria Action Plan (GMAP)

In2005, the proportion of the population sleeping under a bednet wasgenerally low, with only six countries achieving coverage levelsgreater than 20% (see Figure 3.2)[3]. Now many morepeople sleep under bednets, but not everyone who needs a net is able tosleep under one.

Malnutrition: US$ 10billion annually

Arecent review[4] suggeststhe total annual costs of achieving 90% coverage with nutritioninterventions in the the 34 countries that are mostly affected bynutritional deficiencies would cost around $9.6 billion.

Theseestimates are similar to those of recent World Bank study[5],which estimated the nutrition scale up cost gap at $10.3 billion perannum globally. These investments would provide preventive nutritionservices to about 356 million children, save at least 1.1 million livesand 30 million DALYs, and reducethe number of stunted children by about 30 million worldwide (globally161 million under-five year olds were estimated to be stunted in 2013[6]).

NeglectedTropical diseases: US$ 2.3 billionannually

For universalcoverage (atleast 80% of the population) against neglected tropical diseases, whichinclude Dengue fever, Guinea-worm disease, Foodborne trematodiases,Lymphatic filariasis, Schistosomiasis, Soil-transmitted helminths (e.g.hookworm), and Blinding trachoma, the total investment targeted for theperiod 2015–2030 is US$ 34 billion excluding medicines (most of whichhas been pledged as in-kind donations by pharma companies)[7].
Developingcountries will also fund a significant amount of this themselves.

Investmenttargets to overcome the global burden of NTDs are more than doublecurrent levels of foreign aid  (10 times as much whenincludinginvestments in vector control. It is unlikely that an increase in aidof this magnitude can be achieved[8].

HIV/AIDS:US$ 16 billion annually

Tohave 90% percent of people living with HIV diagnosed, on treatment, andvirally suppressed by 2020 requires about US$ 16 billion annually forHIV treatment, including drug costs, service delivery, communitymobilization to ensure access to testing and retention in treatment,and pre-ART costs (see figure above)[9].Achievement of this target by 2020, it is projected that nearly 350 000people will die of AIDS-related causes in 2030, compared to 2.1 milliondeaths with continuation of current ‘constant coverage’ (see figurebelow)[10].

EssentialSurgeries: US$24 billion annually

Figure: Thecost and time needed to scale up the surgical workforce in low-income,lower-middle-income, and upper-middle-income countries in an SAO-onlymodel versus a hybrid task sharing SAO model. The use of task sharingcan decrease costs and time needed to scale up the surgical workforceto 20 providers per 100 000 population by 40%. SAO=surgical,anaesthetic, and obstetric. TS=task sharing. For information onTask-Sharing, see[11]

Arecent study suggested that the total cost of scaling up essentialsurgical services over 2012–30 would be 298-552 billion dollars, whichtranslates to annual average costs of about $16 billion to $31 billionper year[12].Not only does this compares very favourably with estimates of the costsof scaling up services to tackle infectious, maternal, and child deathsabove, but providing essential surgeries can be surprisinglycost-effective and cost as little as $33 per surgical DALY averted insub-Saharan Africa[13].

Annual Globalhealth spending:US$ 31 billion annually

DevelopmentAssistance for Health is only $31.3billion a year (see figure below[14]).

Overall costs andGiving What We Can members required to fund this

|

Overallcosts

| |

Disease:

|

AnnualCosts in Billion US$ dollars

| |

Malaria

|

7.83

| |

Malnutrition

|

10

| |

NeglectedTropical diseases

|

2.3

| |

HIV/AIDS

|

16

| |

EssentialSurgeries

|

24

| |

Sum

|

60.13

| |

AnnualGlobal health spending

|

31.3

|

Thecost of fighting Malaria, Malnutrition, Neglected Tropical Diseases,and HIV/AIDS, and providing Essential Surgeries is about US$ 60billion, but the total development assistance for health is only US$ 30billion. Of course, some low to middle income countries are able to usesome of their limited domestic funds to fund their own health. However,most poor countries are not able to do this. Moreover, this calculationdoes not take into account the many other sources of ill-health.

Wewould need about 9,6 million people who give $3000 a year to effectiveorganisations to close this gap.


[1] "“Towards a Malaria-FreeWorld” was developed … - GMAP2." 10 Jun. 2015 <http://www.gmap2.org/app/download/9918235197/Public%20Review%20Draft_MASTER_17-02-2015.docx?t=1424192319>

[2] "WHO | World MalariaReport 2014." 2014. 27 May. 2015 <http://www.who.int/malaria/publications/world_malaria_report_2014/en/>

[3] "WHO | World MalariaReport 2014." 2014. 27 May. 2015 <http://www.who.int/malaria/publications/world_malaria_report_2014/en/>

[4] Bhutta,Zulfiqar A et al. "Evidence-based interventions for improvement ofmaternal and child nutrition: what can be done and at what cost?." TheLancet 382.9890(2013): 452-477.

[5] Shekar,Meera. Scalingup nutrition: what will it cost?.World Bank Publications, 2010.

[6] "Levels and Trends in Child Malnutrition: Overview … - Unicef." 2014. 1 Jun. 2015 <http://data.unicef.org/corecode/uploads/document6/uploaded_pdfs/corecode/Levels-and-Trends-in-Malnutrition-Overview-2014_203.pdf >

[7] "WHO | Investing toovercome the global impact of neglected …" 2015. 27 May. 2015 <http://www.who.int/neglected_diseases/9789241564861/en/>

[8] "WHO | Investing toovercome the global impact of neglected …" 2015. 27 May. 2015 <http://www.who.int/neglected_diseases/9789241564861/en/>

[9] "90–90–90 - An ambitioustreatment target to help … - UNAids." 2014. 5 Jun. 2015 <http://www.unaids.org/en/resources/documents/2014/90-90-90>

[10] "90–90–90 - An ambitioustreatment target to help … - UNAids." 2014. 5 Jun. 2015 <http://www.unaids.org/en/resources/documents/2014/90-90-90>

[11] Verguet,Stéphane et al. "Timing and cost of scaling up surgical services inlow-income and middle-income countries from 2012 to 2030: a modellingstudy." TheLancet Global Health 3 (2015): S28-S37.

[12] Verguet,Stéphane et al. "Timing and cost of scaling up surgical services inlow-income and middle-income countries from 2012 to 2030: a modellingstudy." TheLancet Global Health 3 (2015): S28-S37.

[13] Meara, JG. "GlobalSurgery 2030: evidence and solutions for achieving …" 2015. <http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60160-X/abstract>

[14] "Financing Global Health2013: Transition in an Age of …" 2014. 11 Jun. 2015 <http://www.healthdata.org/policy-report/financing-global-health-2013-transition-age-austerity>