This paper identifies priorities for disease control as an input into the Copenhagen Consensus 2008 (CC08). As such it updates the evidence and differs somewhat in its conclusions from the communicable disease paper (Mills and Shillcutt, 2004) prepared for Copenhagen Consensus 2004, which Lomborg (2006) summarizes.
The paper builds on the results of the Disease Control Priorities Project (DCPP). The DCPP engaged over 350 authors and among its outputs were estimates of the cost-effectiveness of 315 interventions. These estimates vary a good deal in their thoroughness and in the extent to which they provide regionally specific estimates of both cost and effectiveness. Taken as a whole, however, they represent a comprehensive canvas of disease control opportunities. Some interventions are clearly low priority. Others are attractive and worth doing but either address only a relatively small proportion of disease burden or are simply not quite as attractive as a few key interventions. This paper identifies those key priority interventions and discusses them in the context of a limited range of other possibilities. Separate papers for CC08 deal with malnutrition (Behrman, Alderman, and Hoddinott, this volume), and with water and sanitation (Hutton, this volume).
Section 1 of the paper documents the enormous success in much of the world in the past forty years in improving health in low- and middle-income countries. Its conclusion is that future investments will build on past successes – increasing confidence in the practical feasibility of major additional gains in disease control.