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When Should Governments Subsidize Health? The Case of Mass Deworming

Author

Listed:
  • Amrita Ahuja
  • Sarah Baird

    (George Washington University)

  • Joan Hamory Hicks

    (University of California, Berkeley)

  • Michael Kremer

    (Harvard University)

  • Edward Miguel

    (University of California, Berkeley)

  • 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.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Amrita Ahuja & Sarah Baird & Joan Hamory Hicks & Michael Kremer & Edward Miguel & Shawn Powers, 2014. "When Should Governments Subsidize Health? The Case of Mass Deworming," Working Papers 2014-22, The George Washington University, Institute for International Economic Policy.
  • Handle: RePEc:gwi:wpaper:2014-22
    as

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    File URL: http://www.gwu.edu/~iiep/assets/docs/papers/2014WP/BairdIIEPWP201422.pdf
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    References listed on IDEAS

    as
    1. Donald A P Bundy & Michael Kremer & Hoyt Bleakley & Matthew C H Jukes & Edward Miguel, 2009. "Deworming and Development: Asking the Right Questions, Asking the Questions Right," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(1), pages 1-3, January.
    2. 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.
    3. Hoyt Bleakley, 2010. "Health, Human Capital, and Development," Annual Review of Economics, Annual Reviews, vol. 2(1), pages 283-310, September.
    4. 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.
    5. 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.
    6. 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.
    7. David Laibson, 1997. "Golden Eggs and Hyperbolic Discounting," The Quarterly Journal of Economics, Oxford University Press, vol. 112(2), pages 443-478.
    8. 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.
    Full references (including those not matched with items on IDEAS)

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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. When Should Governments Subsidize Health? The Case of Mass Deworming
      by maximorossi in NEP-LTV blog on 2015-06-04 18:52:47

    Citations

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    Cited by:

    1. Joan Hamory Hicks & Michael Kremer & Edward Miguel, 2015. "The Case for Mass Treatment of Intestinal Helminths in Endemic Areas," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 9(10), pages 1-5, October.
    2. Sarah Baird & Joan Hamory Hicks & Michael Kremer & Edward Miguel, 2016. "Worms at Work: Long-run Impacts of a Child Health Investment," The Quarterly Journal of Economics, Oxford University Press, vol. 131(4), pages 1637-1680.
    3. 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.
    4. Baird, Sarah & Hamory Hicks, Joan & Ozier, Owen, 2020. "Randomized control trial as social observatory: A case study," World Development, Elsevier, vol. 127(C).
    5. Cameron, Lisa & Chase, Claire & Haque, Sabrina & Joseph, George & Pinto, Rebekah & Wang, Qiao, 2021. "Childhood stunting and cognitive effects of water and sanitation in Indonesia," Economics & Human Biology, Elsevier, vol. 40(C).

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    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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