Eradication of Diseases

Economic analysis can have an important role in eradicating and eliminating certain infectious diseases.  It can provide guidance and inform important decisions that will lead to the elimination and eradication to these debilitating diseases.  

Disease elimination should be thought of as a reduction to zero of incidences of infection caused by a pathogen within a geographic area. After elimination there are required interventions to prevent the reestablishment of transmission.  On the other hand, eradication is a permanent reduction to zero of global incidence and does not require additional interventions after eradication. 

An integrated financial and economic analysis of planned investments to eradicate infectious diseases can confirm the best use of resources that will maximize net social benefits.  It will also provide insights on the design as well as the optimal financing structure.  Finally, it can provide a clear analysis of the distribution of the benefits.

Economics has an important role in elimination and eradication, as the initial investments tend to be larger than the existing control programs.  Since there are limited resources the role of economics can be fundamental to making informed choices.

The idea of eradication and elimination have often been challenged, but too often with poorly informed opinions, such as arguments that mass vaccination campaigns underway can lower the incidence of measles, mumps, rubella in poor countries to a range that is similar to rich-world levels.  The argument is that these are ‘good enough’ levels.  The counter argument is that disease can bounce back and have much more dire consequences, as we saw with malaria in the 1960s.  The point is simply that misinformed decisions don’t have to be the case.  There are tools that can be effectively used to make these critical decisions.

We have been able to learn from the experience of small pox (human disease) and rinderpest (cattle disease), as well as from polio and dracunculiasis, a parasitic worm.  There is strong rationale as to why we can eradicate many more diseases.  Improved communication has provided technological responses to locating and monitoring cases of diseases in poor countries.  The use of mobile phones and apps has changed the manner in which disease can be monitored.  Medical technology and advances in drug production have been a huge game changer.  The turning point for NTDs came about when Merck/MSD made the drug ivermectin available to poor countries.  This is a drug that kills the worm that causes filariasis. As such, eradication of filariasis is now possible.  Increasingly, there is political support within poor countries to eradicate diseases, especially those that are extremely cost effective, such as river blindness.

The benefits of eradicating diseases by exterminating the pathogens and parasites that cause them can be seen immediately, especially by those who are suffering from these diseases, but the benefits can have a country-wide impact for many poor countries.  It is now thought that one of the reasons Japan and South Korea developed so quickly after World War II is that both ran country-wide deworming programs.

Ken Gustavsen, the Senior VP of the Merck Foundation, mentioned that eradication is not easy and that “sometimes the last mile is the hardest.”  Mr. Gustavsen is right, but with the right set of tools including those required for the selection and structuring of financing instruments, the last mile can be the most rewarding, as we watch diseases that have caused disabilities to so many people be eradicated.

Employment for People with a Learning Disability

Employment figures for those with a learning disability are difficult to find, and those statistics that are available do not measure employment in the same manner.  Some combine volunteer positions with paid positions; others include paid positions that are subsidized and those being paid at competitive salary grades.   There is a general consensus that about two in ten people living with a learning disability are in employment.

The number of people who have employment will depend on the type of learning disability.  The statistics show that people with Downs Syndrome, who want to work, are slightly over 50%, but is still considerably lower than the number who want to work yet are unable to do so.

It is well recognized that the type of job is important for a person with a learning disability.  Structured roles that are process driven can be an excellent environment for a person with a learning disability, such as Downs Syndrome, to be able to thrive.   For those with autism spectrum disorder (ASD) there tends to be difficulties with social interactions and social communication.  They can feel lost or anxious if an assigned task isn’t clearly explained, or if a sequence of events is not fully understood.  For most people with a learning disability there is a need for predictability, such as consistent work schedules.  This is considered to be one of the most important factors that a person, especially with ASD, needs for her or his success in the job market.

Not all of the challenges in finding meaningful employment for people with learning disabilities are a result of their disability.  Some reasons can be arguably self-imposed, as is the situation in Ontario, Canada, where recent legislation was passed on a new minimum wage for Ontarians.  This same legislation removed the exemption for sheltered workshops who paid below minimum wage.  The decision was made as a human rights issue.  This legislation has begun the process of a mandated phasing out of sheltered workshops by 2019.  For many employers who worked with service providers, the new minimum wage is considered to have too high of a productivity subsidy to hire people with learning disabilities. 

For many employers, it is an issue of productivity and receiving value for an investment in a human resource.  Although the literature is clear that people with learning disabilities require a conducive environment to perform well, it also shows that these people can be competitive for certain jobs.  For many, the challenge is more on inclusion than on the actual value that can be added to an organization.  There is more of a need to support and eliminate barriers related to the different types of disability.  We have come a long way in supporting people with physical and sensory disabilities, but not so for people with learning disabilities.

Impact Bridges Group wants to work with others who are committed to finding innovative solutions to the challenge of finding employment for people with learning disabilities.   Impact Bridges Group is a registered Canadian charity (84309 2297 RR 0001) and can provide tax receipts for donations.  A donation can be made here or on the Donation page.  More information can be provided by contacting us by clicking here.