Ebola kills far fewer than Aids, TB and malaria. What should we prioritise?

Ebola got most of the attention in 2014. It killed about 8,000 people. Meanwhile, over the same period of time about 3.6 million people died from HIV/AIDS, tuberculosis (TB) and malaria.

The truth is that despite great progress in healthcare, much of the world is still blighted by preventable disease, with the poorest people suffering the most. The good news is that tackling these diseases turns out to be an extraordinary good investment.

The Copenhagen Consensus Center has just published new studies that show effective, clear strategies and targets that would dramatically reduce the burden of these deadly diseases.

For malaria, the recommendation is to reduce resistance to artemisinin – the primary drug treatment for malaria – by using combination therapies, while providing bed-nets to reduce infection. Each dollar invested returns $36 in benefits.

For TB, treatment since 1995 has saved 37 million people. We can do even more. The author suggests intensifying efforts to identify TB carriers, particularly among those co-infected with HIV, while scaling up treatment to both regular and drug-resistant strains of TB. Each dollar invested returns $43 in benefits.

For HIV/AIDS, to get the best bang-for-buck the authors suggest focusing on hyper-endemic (15%+ of adult population infected) regions in Africa. By circumcising 90% of HIV-negative men we can get $28 back on the dollar, and focusing on treatment to the most susceptible, we can return $10 for every dollar spent.

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19 Jan 2015

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The Guardian