Five things that won’t do much for global health
We don't like talking about the programs that don't work. No one wants to think of money wasted, or the lives that could have been saved if a program just worked better. Most of the time, bad health programs don't hurt people; they just absorb resources that could have gone to programs that actually did something.
In my opinion, though, saving fewer lives than you could have is almost as immoral as not helping at all. In that context, it's important to look at the things that don't work. Here are five solutions that won't do much at all for global health.
1. Sending excess pharmaceuticals overseas.
This doesn't work because there is very little match between supply and demand. The developing world has different pharmaceutical needs that the wealthy world. Developing countries need antibiotics, painkillers, HIV drugs, and vaccines. The developed world tends to have excesses of drugs like Viagra, blood pressure drugs, and allergy medicine. Sending that to the developing world is worse than doing nothing because it forces recipients to find a safe way to destroy it once it has expired.
2. Sending used medical equipment overseas
Almost all medical equipment used in the developed world is expensive and requires sophisticated maintenance. Donated equipment may not be reparable, and it often breaks down quickly when housed in un-climate controlled buildings with extreme temperatures. Furthermore, providers may not know how to use the equipment, or when it is useful.
3. Hospital ships
Hospital ships serve only coastal populations. They provide one-time treatment that people have to travel a long way to access. They can't give follow-up care. They are staffed by volunteers who have varying degrees of familiarity with the illness of the developing world. They are a band-aid, and not one of those good-quality flexible fabric bandaids. They are a cheap plastic band-aid that won't even stay stuck.
4. Tertiary care hospitals
It's true that the developing world lacks of specialist hospitals. There are few cancer hospitals and few cardiac hospitals. Not many providers can provide ultra high-level care like neurosurgery, cancer treatment, or care for very premature infants. While it's heartbreaking for people to go untreated, a dollar spent on increasing vaccination coverage or improving training for healthcare providers will go a lot farther than a dollar spent on providing specialist care.
Here's a blog post on cervical cancer that offers a different approach, and makes its point well.
5. Sending people to the US for medical care
Sending people to the US for medical care is expensive, logistically complex, and taxes vulnerable people far from their homes and leaves them without emotional support. It also does nothing to build capacity on the health care system of their home country. We can find better ways to help people who can't get care in their home countries.
Isaac Holeman thinks I am wrong about this, and he's got a good point.
COMMENTS (10)