B. Defining Basic Survival Needs as a Measure of International Health Assistance

Reframing the approach to international developmental assistance requires interventions that substantially improve the health and wellbeing of the world’s least healthy people. I propose shifting assistance to what I call basic survival needs, namely those needs essential to restoring human capability and functioning. Basic survival needs include immunizations, essential medicines, nutritional foods, potable water, sanitation, pest abatement, public health infrastructures, primary health care, and health education.

Vaccines are the most cost effective means of preventing infectious diseases that we know. Vaccine-preventable diseases are virtually extinct in developed countries but still kill millions of children and adults annually in poorer regions. Activists fervently lobby for universal access to anti-retroviral (ARV) medications for AIDS, as they should. ARVs now cost hundreds of dollars annually per person, down from thousands, but they must be taken daily and for a lifetime. In contrast, a single annual dose of Mectizan costing a couple of dollars rids the body of intestinal worms, relieves the unbearable itching of river blindness, and prevents loss of eyesight. Basic sanitation and water systems would vastly reduce improve global health at minimal cost, such as clean water kits costing as little as $3. An insecticide-treated bednet, which costs roughly $5, is highly effective in reducing malaria, river blindness, elephantiasis, and other insect-borne diseases among children. But only about one in seven children in Africa sleep under a net, and only 2% of children use a net impregnated with insecticide.

Consequently, something as simple as a vaccine, a generic drug, basic engineering, or sanitation can result in remarkable benefits for the health of the world’s poorest people. It does not take advanced biomedical research, huge financial investments, or complex programs.