Nov 17, 2008

Intervention that Works

by Laura Starita

When we asked Jameel Poverty Action Lab economists Esther Duflo and Abhijit Banerjee in a recent interview to choose an intervention into which they would like to invest a million dollars they didn’t hesitate: incentives for parents to take their children to get immunized. Their reasons were clear: “immunization is something we know makes a huge difference in people’s lives.“ Indeed, research into developing vaccines for a range of widely-felt diseases—from HIV to TB—is often among the top favorite investments for poverty-focused nonprofits.

Last week Foreign Policy reported that some of that recent research has recently come to fruition: a malaria vaccine is ready for trial. The FP warns that the vaccine is only expected to be between 30 percent and 50 percent effective against the disease, given the various malarial strains. But given that between eight-hundred thousand and a million people worldwide die of malaria every year, even 30 percent fewer infections would save many tens of thousands of lives, as well as millions in treatment—that is certainly something to celebrate.

It is important nonetheless not to let premature enthusiasm dampen diligence. Vaccines need to be tested for many years and then integrated into public health protocols before they can reach even part of their impact. And there is no guarantee this vaccine will work at all. Unchecked enthusiasm sometimes causes health officials or pharmaceutical companies to market medicines as miracle cures before they have proven their worth—note the hype/reality-check roller coaster in the past year regarding the human papillomavirus (HPV) vaccines. In the case of malaria, unrealized expectations for this vaccine may result in a decreased use of bed nets or mosquito control efforts, or even a slow-response to symptoms, all of which can be devastating for affected populations. So while we wait for the vaccine’s value to be proven, let’s stick with prevention that works.