The moral imperative toward cost-effectiveness in global health

Abstract

Getting good value for the money with scarce resources is a substantial moral issue for global health. This claim may be surprising to some, since conversations on the ethics of global health often focus on moral concerns about justice, fairness, and freedom. But outcomes and consequences are also of central moral importance in setting priorities. In this essay, Toby Ord explores the moral relevance of cost-effectiveness, a major tool for capturing the relationship between resources and outcomes, by illustrating what is lost in moral terms for global health when cost-effectiveness is ignored. For example, the least effective HIV/AIDS intervention produces less than 0.1 percent of the value of the most effective. In practical terms, this can mean hundreds, thousands, or millions of additional deaths due to a failure to prioritize. Ultimately, the author suggests that creating an active process of reviewing and analyzing global health interventions to deliver the bulk of global health funds to the very best.