TB one of the best investments Bjorn Lomborg C O P E N H A G E N C - PowerPoint PPT Presentation

TB one of the best investments Bjorn Lomborg C O P E N H A G E N C O N S E N S U S . C O M L O M B O R G . C O M

Cost-benefit analysis To help best prioritize the SDG spending

Copenhagen Consensus • We’ve been helping prioritize for 15 years - “Where will the next $ or ₹ do most good?” • Work with 300+ of the world’s top economists - Including 7 Nobel Laureates • The methodology has been applied many places - Haiti, Bangladesh, India and Ghana - How best to fix climate, health, HIV and US schooling - How to prioritize the SDGs

Priorities for the SDGs

Social, economic and environmental benefit per $ spent Social, economic and environmental benefit per $ spent Biodiversity Trade Halve coral reefs loss Reduce world trade restrictions (full Doha) $24 $2011 Halve forest loss Freer Regional Asia Pacific trade $10 $1299+ Halve wetland loss Gender $10 Reforest to store CO2 $7 Universal access to contraception $120 Increase protected areas $0.85 Ensure women’s rights to own and inherit Likely To Be High Infrastructure Increase women’s political representation Likely To Be High Mobile broadband developing countries Increase women’s economic opportunities $17 $7 Universal fixed broadband Enhance female education $5 $5 Conflicts & Violence Vaccinate against cervical cancer $3 Reduce child marriages Likely To Be Low Reduce assaults $17 Illicit financial flows Improve policing Likely To Be High Eliminate violence against women and girls Likely To Be High Make beneficial ownership info public $49 Eliminate violence in child discipline $11 Exchange tax information automatically Likely To Be High More peacekeeping troops Country-reporting for multinationals $5 Likely To Be High Energy Health Phase out fossil fuel subsidies $15+ Aspirin heart attack therapy $63 Modern cooking fuels to 780m people $15 Expanded immunization $60 Modern cooking fuels to everyone $9 High blood pressure medication $47 Electricity to everyone $5 Cut tuberculosis deaths 95% $43 Double energy efficiency Cut salt intake 30% $3 $39 Double renewable energy Halve malaria infections $0.8 $36 Science & technology More male circumcision against HIV $28 Increase skilled worker migration Increase tobacco prices 125% $15 $22 More R&D spending in developing countries More health spending for 1bn poorest $13 $3 Doubling HIV medication for sickest Climate Change $10 Reduce infant mortality $9 More energy research $11 Stroke / Heart attack pill $7 Climate change adaptation $2 More health spending for 2.5bn poorest 2 ° C target $3 <$1 Population & Demography Air Pollution Allow more migration $45+ Better cook stoves to cut indoor air pollution $10 Discourage early retirement Likely To Be High Cut outdoor air pollution $0.3 Promote urbanization Likely To Be High Water & Sanitation Increase birth rates in rich countries <$1 Eliminate open defecation $6 Give public pension for young old ages Low Better access to water for 2.3bn people $4 Food Security and Nutrition Provide basic sanitation for 3bn people $3 Reduce child malnutrition $45 Poverty Research to increase yields $34 End extreme poverty by money transfers $5 Cut food loss with roads and electricity $14 Social protection system coverage <$1 Education Better disaster resilience for poor <$1 Triple preschool in Sub-Saharan Africa $33 Provide employment for all <$1 100% primary education in SSA $7 Increase life satisfaction <$1 Improve exams and teacher accountability $4 Governance & Institutions Increase secondary school completion $4 Provide legal identity for all >$1 More vocational training Uncertain Better institutions Uncertain More training of older workers Uncertain Reduce corruption and bribery Uncertain Data for Development Data collection for all 169 targets <$1

Tuberculosis • Cost - Latent TB screening • $1,592 per TB found and treated (2.7m cases missing each year) = $4.3bn - TB treatment drug sensitive • $387 per person cured (5.8m cases) = $2.2bn - TB treatment multi-drug resistant • $3,228 per person cured (0.5m cases) = $1.6bn - Total cost: $8.1 billion annually or $907 per TB person

Tuberculosis • Benefit - 20 life years on average saved - $1,000 or $5,000 per DALY - 3% or 5% discount rate Benefit per person $1,000 $5,000 3% $14,877 $74,387 5% $12,462 $62,311 - Median benefit: $38,594 - Cost $907 • BCR is 43

• A partnership with Tata Trusts and the Copenhagen Consensus

• With Tata Trusts • Top economists, including Modi’s economic advisor

Tuberculosis #1 • Tuberculosis killed 40,600 in 2016 • 60% go to private care, but get sub-standard treatment • National Strategic Plan: engage with private providers - Subsidies for high-quality diagnostic tests - Free TB treatment for all those treated in the private sector - Adherence support to patients with linkage to a call centre - Provider support for notifying TB • Average cost per year ₹15.2 crores ($2m) • Average benefit per year ₹2,721 crores ($373m) • Each rupee spent on TB will produce ₹171 of social good for Rajasthan

Main point • No matter which way you slice it - Spending on TB is one of the world’s best investments