Despite its economic growth, India trails behind other developing nations in several measures of health; some recent health gains have actually been reversed. And even as old nemeses like malaria, TB, and other infectious diseases continue to afflict Indians, the chronic, noncommunicable diseases characteristic of industrial nations—cardiovascular conditions, respiratory disorders, diabetes, cancers—are increasing. The country must make rational, evidence-based choices about health spending.

Following an approach developed by the Disease Control Priorities Project, an international initiative of the World Health Organization and several collaborators, CDDEP researchers conducted a rigorous analysis of preventable diseases in India and the best ways to tackle them. Researchers identified the most cost-effective interventions against major causes of death and disability and then determined which of these interventions could be feasibly scaled up and practicably deployed.

The result, a major report titled Choosing Health: An Entitlement for All Indians, points the way to a more equitable and effective health system with a package of basic health care interventions that would save millions of lives. In fact, India could greatly improve the health of its people at a relatively low cost. Like all CDDEP research, the report integrates multiple perspectives—from economics, epidemiology, and disease modeling to risk analysis and statistics.

CDDEP researchers are also exploring the value of investing in antibiotics and vaccines in an effort to alleviate future outbreaks and pandemics. Researchers estimated the value of investing in developing and conserving an antibiotic to mitigate the burden of bacterial infections caused by resistant Staphylococcus aureus during a pandemic influenza outbreak. The model, which is based on UK preparedness plan assumptions, found that the value of withholding an effective novel oral antibiotic can be positive and significant unless the pandemic is mild and causes few secondary infections with the resistant strain or if most patients can be treated intravenously.

Fighting Influenza

Like spring, summer, and fall, the winter flu season is a predictable feature of people’s lives around the world. While it typically means a few days off from work for adults, influenza can be a cause of death in the elderly and small children if they are unprotected by vaccination.

Work at CDDEP has focused on the impact of influenza vaccinations both on preventing the flu but also on secondary bacterial infections that may then need a course of antibiotic treatment. We have examined incentives for countries to look for and report outbreaks of novel influenza strains and the design of international mechanisms to encourage faster reporting.

CDDEP researchers have also developed a mathematical framework to estimate the value of investing in developing and conserving an antibiotic to mitigate the burden of bacterial infections caused by resistant Staphylococcus aureus during a pandemic influenza outbreak. In the event of a significant influenza pandemic, secondary infections caused by prevalent pan-drug resistant bacteria could be catastrophic.  Effective antibiotics in the future are indispensable in the case of an influenza pandemic.