Understanding the Economics of Microbial Threats Proceedings of a Workshop (2018) / Chapter Skim
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9 Looking to the Future: Potential Next Steps for Using Economics to Manage Microbial Threats
9 Looking to the Future: Potential Next Steps for Using Economics to Manage Microbial Threats
Pages 97-110
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From page 97... ...
Peter Daszak, president of EcoHealth Alliance, reported on modeling the economics of emerging infectious diseases (EIDs) (group 1)
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From page 98... ...
Potential Next Steps to Improve Economic Models of Emerging Infectious Diseases: Incorporating Behavioral Responses to Fear Daszak stated that many members of the group spoke about the knowledge gaps in understanding the economics of fear associated with outbreaks. Wherever on the spectrum of fear -- from excess to lack of fear, he said, different levels of fear at different population levels, including the household, national, and global levels, at different times can affect the course and the costs of an outbreak.
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From page 99... ...
Daszak emphasized that the equations underlying models could be shared, but the models should then be described to decision makers in a way that better highlights both their usefulness and uncertainty. STIMULATING RESEARCH AND DEVELOPMENT FOR ANTIMICROBIALS Ed Whiting, chief of staff and director of policy at the Wellcome Trust, shared insights from the breakout group that discussed how to stimulate
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From page 100... ...
With the aim of increasing the number of available antimicrobials to fight infectious disease threats, the group discussed approaches to spur drug development including issues related to incentives, and other considerations including filling data gaps and strengthening coordination between national and global level efforts. Potential Next Steps to Stimulate Antimicrobial Development: Addressing Challenges of Incentive Design Whiting shared that many of the participants recognized the need for incentives, particularly pull incentives to accelerate antimicrobial development.
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From page 101... ...
If we are going to put more money into this, how can we get to a place where drugs are brought through the regulatory pathways quickly, but at the same time, are going to be good enough to justify the extra investment that would be made from either a public or payer purse? Policy makers must balance the cost of higher drug prices against other AMR interventions, Whiting added, underscoring that policy makers as well as decision makers in private-sector companies work with "a finite pie." That is, if the pie is cut one way and makes one part bigger, another part of the pie will inevitably be smaller; therefore, equipping decision makers with information to make the best choices is a critical yet grand, "human" challenge, said Whiting.
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INCENTIVIZING NATIONAL GOVERNMENTS TO INVEST IN PREPAREDNESS Anas El Turabi, Frank Knox fellow in health policy at Harvard University, reported for the breakout group focused on incentivizing national governments to invest in preparedness. El Turabi stated that the group discussed specific strategies including synergizing preparedness investments with existing health expenditures and connecting disease risk to foreign direct investment.
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From page 103... ...
Building on existing health expenditure streams would require a different type of economic and cost analysis than what has been previously done, but he said it could be an important shift to encouraging governments to invest in pandemic preparedness. Another strategy raised by some participants involves the private sector, which can be substantially exposed to economic risks from infectious disease threats yet are often excluded as partners from these conversations.
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From page 104... ...
For these situations, the Global Heath Security Index,3 which is in the process of being created by the Nuclear Threat Initiative, Johns Hopkins Center for Health Security, and Economist Intelligence Unit, might be particularly helpful, El Turabi said. Other Potential Considerations: Strengthening Local Capacity and Political Will El Turabi highlighted crosscutting considerations that could incentivize national-level preparedness.
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From page 105... ...
In communicating with the multidisciplinary stakeholders involved in infectious disease response and pandemic preparedness, Meltzer asserted that simple models could be better to avoid creating "black boxes" of information. He noted that although a simple model would not capture all of the social interactions and utilities that policy makers in particular are interested in capturing, some proxies for human behavior, such as compliance to public health measures, could be programmed as a variable changing over time in a simple model, while capturing multiple aspects of behavior.
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From page 106... ...
This requires concerted efforts to better understand the "customers" of these models, he noted, which include decision makers who allocate resources to manage microbial threats. He said that researchers need to understand the customers' inputs in the decision-making process and produce models that allow for analyses that will influence those inputs.
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From page 107... ...
El Turabi called for programs that cultivate more health economists and computational data scientists specifically for pandemic security and become mainstream in existing development activities. The discussion transitioned to the need for more data, with El Turabi mentioning more efforts are needed to collect more microlevel data to make 4 PEFis a quick disbursing financing mechanism that provides surge funds to enable a rapid response to a major infectious disease outbreak.
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From page 108... ...
Daszak emphasized that next steps should center on gathering different types of data to support modeling -- both disease data on individual spillover events that will inform different scale outbreaks, and social and behavioral science data that can be generalized using appropriate proxies. The discussion ended with a conversation about the economics and costing issues of medical products to counter infectious diseases.
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From page 109... ...
What is the opportunity cost of investing in TB drugs and forgoing other health interventions? And to what extent should other complementary health interventions be developed, whether that means drug susceptibility testing or the introduction of a new vaccine, and how does that affect drug pricing commitments?
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