Trade, foreign policy, diplomacy and health

3. Tuberculosis control

Jim Yong Kim, Aaron Shakow, Arachu Castro, Chris Vande, Paul Farmer


Conclusion

  • GPGH analysis moves beyond nation-state based cost-effectiveness analyses
  • Stop TB partnership should reduce the ‘prisoner’s dilemma’
  • GPGH concept brings attention to the problem of market failure
  • Overall, GPGH useful tool of analysis and advocacy

The GPGH concept could serve to both increase external funding for TB programs and push those involved in TB control to embrace an ambitious, comprehensive global plan that would move the world toward TB elimination.

  • The GPGH analysis moves beyond nation-state based cost-effectiveness analyses. DOTS may be one of the most cost-effective interventions in public health, but in many regions of the world will not be enough. Decisions for TB control in places with MDR-TB and HIV should not be made on simple national cost-effectiveness analyses, as these are a global problem. The GPGH concept gives us a way to begin the discussion about appropriate responses.
  • The Stop TB partnership, a cental information management and dissemination mechanism, should reduce the 'prisoner's dilemma’, especially through its close relationship with WHO
  • The GPGH concept also brings attention to the problem of market failure in responding to problems like TB, such as in reducing the price of second-line TB drugs.

Overall, the notion of GPGH is a tool of analysis and advocacy, a way of expressing the relationship between individuals and collectivities on a global scale, rather than as a policy measure per se. In order for global public goods to become tangible to the world community, they must be insisted upon and actively asserted.

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