The Economic Control of Infectious Diseases

Gersovitz, Mark ; Hammer, Jeffrey S.

World Bank, Washington, DC

关键词: BIOLOGY;    BIRTH RATE;    CONDOMS;    DEATH RATE;    DECENTRALIZATION;   

DOI  :  10.1596/1813-9450-2607
RP-ID  :  WPS2607

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Despite interesting work on infectiousdiseases by such economists as Peter Francis, MichaelKremer, and Tomas Philipson, the literature does not set outthe general structure of externalities involved in theprevention, and care of such diseases. The authors identifytwo kinds of externality. First, infectious people caninfect other people, who in turn can infect others, and soon, in what the authors call the pure infection externality.In controlling their own infection, people do not take intoaccount the social consequence of their infection. Second,in the pure prevention externality, one individual'spreventive actions (such as killing mosquitoes) may directlyaffect the probability of others becoming infected, whetheror not the preventive action succeeds for the individualundertaking it. The authors provide a general framework fordiscussing these externalities, and the role of governmentinterventions to offset them. They move the discussion awayfrom its focus on HIV (a fatal infection for which there arefew interventions), and on vaccinations (which involveplausibly discrete decisions), to more general ideas ofprevention, and cure applicable to many diseases for whichinterventions exhibit a continuum of intensities, subject todiminishing marginal returns. Infections, and actions toprevent, or cure them entail costs. Individuals balancethose parts of different costs that they can actuallycontrol. In balancing costs to society, government policyshould take individual behavior into account. Doing sorequires a strategy combining preventive, and curativeinterventions, to offset both the pure infectionexternality, and the pure prevention externality. Therelative importance of the strategy's componentsdepends on: 1) The biology of the disease - includingwhether an infection is transmitted from person to person,or by vectors. 2) The possible outcomes of infection: death,recovery with susceptibility, or recovery with immunity. 3)The relative costs of the interventions. 4) Whetherinterventions are targeted at the population as a whole, theuninfected, the infected, or contacts between theuninfected, and the infected. 5) The behavior of individualsthat leads to the two types of externalities.