When Should Governments Subsidize Health? The Case of Mass Deworming

25 Pages Posted: 11 May 2015

See all articles by Amrita Ahuja

Amrita Ahuja

Harvard University - Harvard Kennedy School (HKS)

Sarah Baird

George Washington University - School of Public Health and Health Services (SPHHS)

Joan Hicks

University of California, Berkeley - Center for Effective Global Action (CEGA)

Michael Kremer

Harvard University - Department of Economics; Brookings Institution; National Bureau of Economic Research (NBER); Center for Global Development; Harvard University - Harvard Kennedy School (HKS)

Edward Miguel

University of California, Berkeley - Department of Economics; National Bureau of Economic Research (NBER)

Shawn Powers

GSU; Massachusetts Institute of Technology (MIT) - Abdul Latif Jameel Poverty Action Lab (J-PAL)

Date Written: May 2015

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

Ahuja, Amrita and Baird, Sarah and Hicks, Joan and Kremer, Michael R. and Miguel, Edward and Powers, Shawn, When Should Governments Subsidize Health? The Case of Mass Deworming (May 2015). NBER Working Paper No. w21148. Available at SSRN: https://ssrn.com/abstract=2604829

Amrita Ahuja (Contact Author)

Harvard University - Harvard Kennedy School (HKS) ( email )

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Sarah Baird

George Washington University - School of Public Health and Health Services (SPHHS) ( email )

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Joan Hicks

University of California, Berkeley - Center for Effective Global Action (CEGA) ( email )

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Michael R. Kremer

Harvard University - Department of Economics ( email )

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Brookings Institution

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National Bureau of Economic Research (NBER) ( email )

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Center for Global Development

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Harvard University - Harvard Kennedy School (HKS) ( email )

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Edward Miguel

University of California, Berkeley - Department of Economics ( email )

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National Bureau of Economic Research (NBER)

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Shawn Powers

GSU ( email )

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Massachusetts Institute of Technology (MIT) - Abdul Latif Jameel Poverty Action Lab (J-PAL) ( email )

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77 Massachusetts Avenue
Cambridge, MA 02139
United States

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