health is the first and the greatest of all blessings

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Lord Chesterfield observed that good health is the first and greatest of all blessings and the first of all liberties. Millions of people in developing countries around the globe lack this blessing and basic freedom. What's more, their poor health both reflects their poverty and contributes to it. Economists have found a strong correlation between better health and faster economic growth--a correlation that holds up even after accounting for other factors that explain national differences in economic progress. Providing adequate health services to the world's poorest citizens could save millions of lives each year, reduce poverty, and promote development. Laudable as this goal is, can it be achieved? A carefully researched report from a World Health Organization commission chaired by Jeffrey Sachs of Harvard University--on which I served--concludes that the answer is yes.

A relatively small number of identifiable conditions--such as malaria, tuberculosis, childhood infectious diseases, maternal and perinatal nutritional deficiencies, and HIV/AIDS--are the main causes of illness and high mortality rates in developing countries. For each of these conditions, interventions that can dramatically improve health outcomes already exist. Most such interventions are not technically exacting and can be delivered by local health centers, working with state and private health-care providers and nongovernmental organizations.

Spending on health in the developing countries must increase significantly over the next decade, however. The WHO commission--known formally as the Commission on Macroeconomics & Health--estimates that the minimum cost of essential treatments, including those necessary to fight the AIDS pandemic, is between $30 and $40 per person per year in those countries.

This sounds like a trivial amount compared with average per-capita annual health spending of $2,000 in high-income countries. But it is considerably more than the average per-capita health spending of $13 per year in the poorest countries. Even if developing countries significantly increase the resources they devote to health and use such resources more efficiently, the WHO commission concludes that developed countries must contribute an additional $27 billion per year by 2007. This increase is large compared with their current contribution of about $6 billion per year, but it would amount to only about 0.1% of the gross domestic product of the developed countries, leaving ample resources for other developmental goals.