Bjørn Lomborg, the president of the think tank Copenhagen Consensus Center, in this interview with SYLVESTER ENOGHASE, speaks on how conducting a cost-benefit assessment on Healthcare in Nigeria would make Federal Government spend its resources most effectively to achieve the greatest amount of social good for Nigerians. Excerpts:
Could you please, give highlights of why you are here in Nigeria?
I am in Nigeria to contribute to the Africa Dialogue on Financing to End Tuberculosis and to suggest the best policies for Nigeria
I have in the last few days in Nigeria to suggest and give reasons on why investing in tuberculosis diagnosis and treatment is one of the world’s most efficient policies.
I met with the Health Ministers of the Philippines Dr. Herbosa, Indonesia, Nigeria, and South Africa, as well as many other notabilities, and I have been able to convince African leaders that every dollar spent delivers an astounding $46 of social good.
I had several meetings with multiple Nigerian politicians and public institutions about conducting a cost-benefit assessment of where the country could spend its resources most effectively to achieve the greatest amount of social good for its citizens.
Besides meeting several times with the Nigeria Health Minister, Dr. Muhammad Pate, I also met with Prof. Sulaiman, head of the 400-person National Institute for Legislative and Democratic Studies to discuss how tuberculosis, the world’s most deadly infectious disease last year, killing 1.25 million people and proffer solutions
These solutions are seldom making headlines, but they are cheap and incredibly powerful as specified the global plan to end TB, 2023–2030
Following your interventions on African health policies in Nigeria, how do you see other world leaders adhering to the global plan to end TB, 2023–2030 from next year?
There is hope that African leaders with adhere to recent global modeling exercise conducted for the Global Plan to End TB, 2023–2030.
The Global Plan provides aspirational scenarios to reduce the number of TB deaths and the TB incidence by 90% and 80%, respectively, by 2030 relative to 2015 in line with the UN’s Sustainable Development Goals.
The Global Plan, commissioned by the Stop TB partnership, is a collaborative and inclusive document, developed with the input of numerous partners, including the Copenhagen Consensus, stakeholders, and experts over the course of almost 2 years.
The plan calls for scaling up existing tools for addressing TB—such as molecular diagnostics and approaches for early case finding—as well as funding and deploying innovations, such as digital adherence tools and a new vaccine over the period 2023 to 2030.
The Global Plan reports that US$ 250 billion in funding would be required between 2023 and 2030 to implement the plan, leading to 6.6 million averted deaths and 234 million averted disability-adjusted-life-years.
The analysis takes the Global Plan modeling as the starting point to conduct benefit–cost analysis for the Halftime SDG Series.
While it was not constructed as an optimisation exercise, it can provide insight into a plausible range of BCRs for increased funding to TB.
The primary baseline used to assess marginal benefits and costs is one where TB burden follows the steady downward trajectory prior to the COVID-19 pandemic, without any assumed disruption in TB notifications and treatment after 2022.
This baseline assumes TB services have recovered fully during 2022 and reverted to pre-pandemic trends.
In 2030, incremental costs total US$ 5.2 billion, and in 2050, an extra US$ 2.6 billion is required. Importantly, these costs include health system costs and substantial markups beyond patient costs such as programme costs and enablers, meaning they are likely to represent long-term resource needs.
With this funding, incremental averted cases and deaths are 370,000 and 85,000, respectively, in the first year and continue rising over time.
By 2030, LLMCs see 4.5 million fewer cases and 906,000 fewer deaths compared to a standard baseline
By 2050, there are 8.0 million fewer incremental cases and 1.4 million fewer incremental deaths.
Could you please, give us the objectives of the global plan to end TB, 2023–2030?
The Global Plan is a collaborative document that was developed over 2021 and 2022.
The aim of the plan was to identify and model interventions that would end TB as a public health challenge by 2030, defined as a reduction in number of TB deaths and TB incidence per 100,000 by 90% and 80%, respectively, relative to 2015.
The Global Plan calls for a series of major activities, each with multiple interventions like: scaling up TB diagnosis and care such as modern diagnostics, integration of screening and testing with other health services, expanding screening for early detection of TB, and support for patients to avoid catastrophic costs.
Scaling up TB prevention such as preventative treatment for contacts and those living with HIV, airborne infection prevention and control, addressing risk factors for TB, and deploying a new vaccine.
Partnering with key stakeholders, the community and private sector, including supporting community-based and home-based models for delivering TB prevention and care, and scaling up public–private mix approaches to improve the quality of TB care.
Ending TB through universal health coverage, pandemic preparedness and response, and socioeconomic actions including expanding access to TB services through universal health coverage initiatives and positioning the TB response at the center of pandemic preparedness and response efforts.
Considering human rights, stigma, gender, and key and vulnerable populations including positioning universal human rights as the foundation of the TB response, eliminating TB-related stigma and discrimination, and ensuring that TB interventions are gender sensitive and gender transformative.
Accelerating development of new TB tools including investing, at minimum, US$ 5 billion annually to accelerate the R&D of new TB diagnostics, medicines, and vaccines, developing a new TB vaccine by 2025, and investing at least US$ 800 million annually in basic science research.
The total undiscounted funding requirement is reported as US$ 250 billion across 2023 to 2030 with approximately US$ 210 billion for service delivery and US$ 40 billion for R&D.
With these interventions, epidemiological modeling projects that the Global Plan would drive down cases and deaths with a particularly rapid decrease between 2025 and 2028.
Across 2023–2030, the Global Plan predicts 43 million averted cases, 6.6 million averted deaths, and 234 million averted daily.
Could you please, be specific on how TB investment would avert substantial mortality?
This report also shows that TB investment would avert substantial mortality, estimated at 27.3 million averted deaths over the 28-year period between 2023 and 2050 inclusive: almost 1 million averted deaths per year on average.
Accounting for all estimated direct and indirect costs, the cost per averted death is slightly over US$ 2000. Interventions to address TB represent exceptional value-for-money.
Sir, could please, be specific on your prospect for 2025?
It is encouraging to see that 2024 was the year that likely steered us onto a path of more effective and reasonable climate policy.
There has been an undeniable backlash to inefficient and expensive climate policies in many elections, most notably in the US and Europe, and I am hopeful that the incoming US administration will shift the focus of its climate policy more towards green R&D.
The recent statements made by the nominee for Energy Secretary, who has publicly echoed many of my longstanding arguments, give me hope for an overdue course correction.
We have also observed a tremendous appetite for a more nuanced, fact-based debate on climate after years of fear-mongering.
Let us hope the world can become even more focused on the most efficient policies.
We at the Copenhagen Consensus have certainly pushed hard for this over the past year.
We have worked with Zambia, Namibia, Uzbekistan, Eswatini, and Uganda to highlight the most efficient policies, such as tuberculosis, malaria, nutrition and education. For instance, in the Pacific island of Tonga, we presented a new report on the best solutions for the nation, together with the Prime Minister, Speaker of the Parliament, and the Crown Prince.
We’ve talked prioritisation with Ministers and other high-ranking government officials of countries including India, Argentina, Brazil, Nigeria, Malawi, Ghana, New Zealand, Indonesia, the Philippines, and Peru.
The interest in and positive reviews for Best Things First have exceeded our wildest expectations.
Next year, 2025 to be precise, it will be published in more languages.
I have also had the privilege of presenting it to the foreign aid agencies of Japan, Australia, New Zealand, and Norway, and to the yearly gathering of Chief Economists from all development agencies.
What do you anticipate or your gesture for a New Year’s resolution?
As we approach the New Year, we need to stop chasing grand lists of unachievable goals and focus on what’s working.
Our resolution should be to direct whatever resources we have —our time, attention, money, or political will — toward the actions that bring about the greatest improvements in people’s lives.
Across hundreds of pages of peer-reviewed, free analysis, we have identified the 12 smartest things we could do to make life better for the poorer half of the planet.
PROFILE:
Dr. Bjorn Lomborg researches the smartest ways to improve the environment and the world.
He is the author of several best-selling books, Visiting Fellow at Stanford University’s Hoover Institution, and he has worked with many hundreds of the world’s top economists, including seven Nobel Laureates. TIME Magazine has named him one of the world’s 100 most influential people.
Lomborg is a frequent commentator in print and broadcast media, for outlets including the Wall Street Journal, New York Times, Times of India and China Daily. His monthly columns are published in 35+ newspapers across all continents in more than a dozen languages.
The Copenhagen Consensus Center was named Think Tank of the Year in International Affairs by Prospect Magazine. It has repeatedly been top-ranked by University of Pennsylvania in its global overview of think tanks.
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