Work

Ethical Considerations for Global Health Decision-Making: Justice-Enhanced Cost-Effectiveness Analysis of New Technologies for Trypanosoma brucei gambiense

Year: 2018

Type: article

Abstract: (Gambiense HAT) would exacerbate or alleviate experiences of societal disadvantage that traditional economic evaluation does not take into account. Justice-enhanced cost-effectiveness analysis (JE-CEA) is a normative approach under development to address social justice considerations in public health decision-making alongside other types of analyses. It aims to assess how public health interventions under analysis in comparative evaluation would be expected to influence the clustering of disadvantage across three core dimensions of well-being: agency, association and respect. As a case study to test the approach, we applied it to five strategies for Gambiense HAT control and elimination, in combination with two different other evaluations: a cost-effectiveness analysis and a probability of elimination analysis. We have demonstrated how JE-CEA highlights the ethical importance of adverse social justice impacts of otherwise attractive options and how it indicates specific modifications to policy options to mitigate such impacts. JE-CEA holds promise as an approach to help decision makers and other stakeholders consider social justice more fully, explicitly and systematically in evaluating public health programs.

Source: Public Health Ethics

DOI: 10.1093/phe/phy013

Authors: Maria W Merritt, C Simone Sutherland, Fabrizio Tediosi

Institutions: Johns Hopkins University, Johns Hopkins Berman Institute of Bioethics, Swiss Tropical and Public Health Institute, University of Basel

Language: English

Topic: Health Systems, Economic Evaluations, Quality of Life

Subfield: Economics and Econometrics

Field: Economics, Econometrics and Finance

Domain: Social Sciences

SDGs: Reduced inequalities, Good health and well-being

Open Access status: bronze

Funders: Bill and Melinda Gates Foundation, Greenwall Foundation, National Institutes of Health, National Institute of Allergy and Infectious Diseases