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When Should Governments Subsidize Health? The Case of Mass Deworming

Author

Listed:
  • Amrita Ahuja
  • Sarah Baird
  • Joan Hamory Hicks
  • Michael Kremer
  • Edward Miguel
  • Shawn Powers

Abstract

We discuss how evidence and theory can be combined to provide insight on the appropriate subsidy level for health products, focusing on the specific case of deworming. Although intestinal worm infections can be treated using safe, low-cost drugs, some have challenged the view that mass school-based deworming should be a policy priority. We review well-identified research which both uses experimental or quasi-experimental methods to demonstrate causal relationships and adequately accounts for epidemiological externalities from deworming treatment, including studies of deworming campaigns in the Southern United States, Kenya, and Uganda. The existing evidence shows consistent positive impacts on school participation in the short run and on academic test scores, employment, and income in the long run, while suggesting that most parents will not pay for deworming treatment that is not fully subsidized. There is also evidence for a fiscal externality through higher future tax revenue, which may exceed the cost of the program. Our analysis suggests that the economic benefits of school-based deworming programs are likely to exceed their costs in places where worm infestations are endemic. This would likely be the case even if the benefits were only a fraction of estimates in the existing literature.

Suggested Citation

  • Amrita Ahuja & Sarah Baird & Joan Hamory Hicks & Michael Kremer & Edward Miguel & Shawn Powers, 2015. "When Should Governments Subsidize Health? The Case of Mass Deworming," World Bank Economic Review, World Bank Group, vol. 29(suppl_1), pages 9-24.
  • Handle: RePEc:oup:wbecrv:v:29:y:2015:i:suppl_1:p:s9-s24.
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    File URL: http://hdl.handle.net/10.1093/wber/lhv008
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    References listed on IDEAS

    as
    1. Hoyt Bleakley, 2010. "Health, Human Capital, and Development," Annual Review of Economics, Annual Reviews, vol. 2(1), pages 283-310, September.
    2. Mark M. Pitt & Mark R. Rosenzweig & Mohammad Nazmul Hassan, 2012. "Human Capital Investment and the Gender Division of Labor in a Brawn-Based Economy," American Economic Review, American Economic Association, vol. 102(7), pages 3531-3560, December.
    3. Bleakley, Hoyt & Miguel, Edward & Kremer, Michael R. & Jukes, Matthew & Bundy, Donald A. P., 2009. "Deworming and Development: Asking the Right Questions, Asking the Questions Right," Scholarly Articles 4460861, Harvard University Department of Economics.
    4. repec:aea:aejapp:v:10:y:2018:i:3:p:235-62 is not listed on IDEAS
    5. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    6. Owen Ozier, 2018. "Exploiting Externalities to Estimate the Long-Term Effects of Early Childhood Deworming," American Economic Journal: Applied Economics, American Economic Association, vol. 10(3), pages 235-262, July.
    7. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2, 00.
    8. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 73-117.
    9. David Laibson, 1997. "Golden Eggs and Hyperbolic Discounting," The Quarterly Journal of Economics, Oxford University Press, vol. 112(2), pages 443-478.
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    Cited by:

    1. International Food Policy Research Institute (IFPRI), 2016. "Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030," IFPRI books, International Food Policy Research Institute (IFPRI), number 978-0-89629-584-1, OCTOBER.

    More about this item

    JEL classification:

    • H2 - Public Economics - - Taxation, Subsidies, and Revenue
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I2 - Health, Education, and Welfare - - Education
    • I20 - Health, Education, and Welfare - - Education - - - General
    • I25 - Health, Education, and Welfare - - Education - - - Education and Economic Development
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty
    • O1 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development

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