The Nobel Prize in Economics 2019: Responsibility Amidst the Chase for Numbers

Abhijit Banerjee, Esther Duflo and Michael Kremer won the Economics Nobel Prize. It is “their experimental approach to alleviating global poverty” that is recognized by the Nobel committee. Development economics has many factions and debates, and the “randomistas” have their many critics, as this movement’s advocates are called, for their adherence to randomized trials, just like in medicine, to do specific and highly localized studies to see the impact of economic programs.
(This link is a great introduction to the critique of the methodology of 2019’s winners) https://www.opendemocracy.net/en/oureconomy/impoverished-economics-unpacking-economics-nobel-prize/ )

We would like to point to their efforts at poverty reduction in the area of immunization. (See: https://www.povertyactionlab.org/evaluation/improving-immunization-rates-through-regular-camps-and-incentives-india ) Immunization from diseases is one of the cheapest and most effective anti-poverty approaches to helping the poor, as diseases punish the poor for their economic standing more than anything can, and to have a sick child in a family depletes whatever else the poor may have, preventing a move out of extreme poverty.

The Dengvaxi scandal has set back immunization efforts not only in the Philippines, but globally, feeding the anti-immunization movements with more energy than fraudulent data or pseudo-science has done. There is no need to discuss medical equipment placed in remote areas where there are no doctors who can use them, as that seems more obvious in the waste of resources. The immunization issue, or the Dengvaxia scandal, has focused largely on how dengue has come back to us in its seasonal surges with incredible vengeance, but that polio, that has largely disappeared, is back. But what is not told to us are the stories and data that will show, the misallocation of resources did not just hurt the poor with diseases, which endangers the whole global community (many countries are now starting to require proof of polio shots), but that those who are poor have become poorer, not only because of the sickness that has come to haunt the homes of countless families, the delivery of vaccines has become more expensive, with the need to allocate resources for campaigns to reverse the misconceptions about vaccines. The the low uptake makes the distribution higher in cost as well, as has been pointed out by this year’s Noble laureates in economics. (See: https://www.flipscience.ph/health/dengvaxia-scare-philippines-i/ )

It is a good reminder for those of us in health care, its many moving parts: technical, policy, business, politics, logistics part of this incredibly complex industry, because it is an industry: we are all chasing numbers, and multinational behemoths constantly pushing for quotas not annually, but quarterly (every three months) must be re-calibrated.The technological advances in medical equipment and wonderful new breakthrough drugs are not in question: it is our chase for numbers that have made the poor so much poorer, and no one wants to talk about this.