Health and Development

The potential consequences of a virulent epidemic in an era of rapid global travel make it essential to understand what factors motivate governments to report disease outbreaks or attempt to conceal them. By reporting an outbreak, a country may obtain international medical assistance, but trading partners may then impose costly trade and travel sanctions. The greater the return (or the penalty) for reporting an outbreak, the greater the return (or the cost) for detecting the outbreak in the first place. These incentives and disincentives thus affect the country’s decision on how much to allocate to surveillance.
 
To see how incentives are influenced by the speed of transmission of the disease, the quality of surveillance data, and the availability of vaccines, CDDEP researchers built a game-theory model to capture the basic dynamics. The findings shed light on why countries have failed to cooperate fully on surveillance and reporting and also point the way toward better cooperation. More valuable medical assistance and perhaps financial transfers to offset the cost of reporting sanctions would be useful; limits on sanctions, especially sanctions based on fears of undetected outbreaks, are not.
 
Researchers then used a bioeconomic model to study the effect of incentives on surveillance and reporting. The findings confirm that the World Health Organization should take into account a country’s incentives to look for and report disease outbreaks, notwithstanding its legal obligations. As with other global public goods, one country’s failure to act promptly could have serious consequences for the whole world.

Publications

Many high-income countries have surveillance systems that keep track of antimicrobial resistance (AMR) rates, but very few low- and middle-income countries (LMICs) do. Can networks of private...
Does India’s Integrated Child Development Services (ICDS), which provides daily supplemental nutrition and an array of services such as immunization and health checkups to pregnant women and...

Blog

How exactly does globally increasing livestock antibiotic use adversely affect human health? PRI's Living On Earth explores.
 
In 2013, tuberculosis (TB) claimed an estimated 1.1 million HIV-negative lives and 0.36 million HIV positive lives [1]. While the TB incidence rate has fallen by approximately...

Tools

Researchers and healthcare agencies often rely onadministrative information to track rates of infections with the antibiotic-resistant bacteria called MRSA (methicillin-resistant Staphylococcus aureus). Despite of frequent revisions to coding guidelines, billing data is subject to human error and cannot capture the full complexity of clinical care.
Pneumococcal disease is a leading cause of death for children under 5, particularly in developing countries. Using data from a 2000 WHO study, this graph shows the number of deaths per 100,000 children under 5 attributable to invasive pneumococcal disease, across six countries. Pneumococcal disease is frequently vaccine-preventable.