Health Expenditure, Institutions, and Economic Growth: Insights From Selected MENA Countries

Health expenditure plays an important role in nation-building. Moreover, the current wave of the COVID-19 pandemic highlights the importance of health investments in maintaining a healthier economy across the world. Quite a significant number of empirical research undertaken on the relationship between health expenditure and economic growth produce mixed results. The study plans to study the relationship between health expenditure and economic growth and the role of institutions in causing health expenditure to promote growth. The study analyses this relationship using the case of seven selected MENA countries between 2000 and 2017. The Pedroni cointegration test reports a long-run cointegrating relationship between the variables. However, the Granger Causality test finds no casual relationships between health expenditure and economic growth. The study further applies panel OLS, FMOLS, and DOLS, and the result from all three models shows that health expenditure does not directly contribute to higher economic growth in the MENA countries. The study argues that this is possibly due to inadequate institutional quality. However, it is understandable that there must be indirect effects of health expenditure on economic growth through better human capital. Finally, the study discusses policy options to improve institutional quality indicators to tap the benefits and contribute positively to economic growth in the region.

Understanding childhood immunizations, their serological interpretation and vaccines - A review article

The practice of immunization dates back hundreds of years. Buddhist monks drank snake venom to confer immunity to snake bite and variolation (smearing of a skin tear with cowpox to confer immunity to smallpox) was practiced in 17th century China. Edward Jenner is considered the founder of vaccinology in the West in 1796, after he inoculated an 8 year-old-boy with vaccinia virus (cowpox), and demonstrated immunity to smallpox. In 1798, the first smallpox vaccine was developed. Over the 18th and 19th centuries, systematic implementation of mass smallpox immunization culminated in its global eradication in 1979. Vaccination is when a vaccine is administered to you (usually by injection). Immunization is what happens in your body after you have the vaccination. The vaccine stimulates your immune system so that it can recognize the disease and protect you from future infection (i.e., you become immune to the infection.). Immunization is a proven tool for controlling and eliminating life-threatening infectious diseases and is estimated to avert between 2 and 3 million deaths each year. It is one of the most cost-effective health investments, with proven strategies that make it accessible to even the most hard-to-reach and vulnerable populations. It has clearly defined target groups; it can be delivered effectively through outreach activities; and vaccination does not require any major lifestyle change.

Call the midwife. Health personnel and mortality in Norway 1887–1920

At the turn of the twentieth century, Norway, like many other countries, experienced a decrease in mortality and a substantial increase in the number of health personnel. In order to assess how these changes were connected, we investigate the relationship between health personnel and mortality using data at the medical district level ($$N=106$$ N = 106 ) covering a period of 34 years. We find a large and robust effect of midwives on reduced maternal mortality in rural areas, but no effect in urban areas. No clear effect is found for other types of health personnel or on infant mortality. The results demonstrate the important role played by public health investments during the period.

Twenty-year economic impacts of deworming

Estimating the impact of child health investments on adult living standards entails multiple methodological challenges, including the lack of experimental variation in health status, an inability to track individuals over time, and accurately measuring living standards and productivity in low-income settings. This study exploits a randomized school health intervention that provided deworming treatment to Kenyan children, and uses longitudinal data to estimate impacts on economic outcomes up to 20 y later. The effective respondent tracking rate was 84%. Individuals who received two to three additional years of childhood deworming experienced a 14% gain in consumption expenditures and 13% increase in hourly earnings. There are also shifts in sectors of residence and employment: treatment group individuals are 9% more likely to live in urban areas, and experience a 9% increase in nonagricultural work hours. Most effects are concentrated among males and older individuals. The observed consumption and earnings benefits, together with deworming’s low cost when distributed at scale, imply that a conservative estimate of its annualized social internal rate of return is 37%, a high return by any standard.

The ethics of resource allocation in translational genomic medicine

Two basic models of the rationale of translational genomic medicine (TGM)—the “Lab Assisting Clinic” (LAC) and the “Clinic Assisting Lab” (CAL) models—are distinguished, in order to address the ethics of allocating resources for TGM. The basic challenge of justifying such allocation is for TGM to demonstrate sufficient benefits to justify the opportunity cost of lost benefits in other areas of medicine or research. While suggested ethics frameworks for translational medicine build on clearly distinguishing these models, actual TGM typically blurs them. Due to lack of and difficulty in collecting evidence, prospects for justifying the LAC model currently seem poor, but this difficulty might be overcome by more research that tests the very concept of TGM. The CAL model aims to thus advance science, but is ridden by ethical hazard, undermining attempts at justification. This leaves the notion of running bona fide controlled trials of entire TGM concepts that have been justified from the perspective of clinical and research ethics (and approved by IRBs). It remains, however, an open question if the outcomes of such trials will demonstrate benefits that can justify the investment in TGM. To advance the prospect of such justification further, charting of the cost-benefit profile of TGM compared to alternative health investments would be helpful.

Fare well to Nova Scotia? Public health investments remain chronically underfunded

Inspired by Fiset-Laniel et al.’s (2020) article entitled “Public health investments: neglect or wilful omission? Historical trends in Quebec and implications for Canada”, we assessed public health investments since the establishment of the Nova Scotia provincial health authority in 2015. We analyzed Nova Scotia Department of Health and Wellness budgets from 2015−2016 to 2019–2020 and observed that less than 1% of funding was budgeted for public health annually, an amount well below the recommendation that 5–6% of healthcare funding be spent on public health. Healthcare spending has increased annually since 2015–2016, but proportions of funding to different programs and services have remained static. Specifically, we did not observe a change in investment in public health over time, suggesting that while the government does not necessarily spend too much or too little on healthcare, it spends far too little on public health. This chronic under-funding is problematic given the high rates of non-communicable diseases in Nova Scotia and health inequities experienced within the population. The 2020 COVID-19 pandemic has highlighted the importance of public health work, and the need for a pandemic recovery plan that prioritizes investment in all areas of public health in Nova Scotia.