Sudhir Anand

This book is motivated by the idea that the cost of inaction can be much greater than the cost of action. Inaction can lead to serious negative consequences—for individuals, the economy, and society. The consequences of a failure to reduce extreme poverty, for example, typically include malnutrition, preventable morbidity, premature mortality, incomplete basic education, and other human and social development costs. In this volume, the authors seek to clarify exactly what is meant by “cost of inaction.” They develop a methodology to account for the consequences and estimate the costs of a failure to respond to the needs of children and their families. Their conceptual framework emphasizes the need to select appropriate actions against which inaction is evaluated. The authors present the results of applying the cost of inaction (COI) approach to six case studies from Rwanda and Angola. The case studies highlight important differences between the COI approach and benefit-cost analysis as it is traditionally implemented.

In the last fifty years, average overall health status has increased more or less in parallel with a much celebrated decline in mortality, attributed mostly to poverty reduction, sanitation, nutrition, housing, immunization, and improved medical care. It is becoming increasingly clear, however, that these achievements were not equally distributed. In most countries, while some social groups have benefited significantly, the situation of others has stagnated or may even have worsened. If health is a prerequisite to a person functioning as an agent, inequalities in health constitute inequalities in people's capability to function -- a denial of equality of opportunity. So why should a concern with health equity be singled out from the pursuit of social justice more generally? Can existing theories of justice provide an adequate account of health equity? And what ethical problems arise in evaluating health inequalities? These are some of the important questions that this book addresses in building an interdisciplinary understanding of health equity. With contributions from distinguished philosophers, anthropologists, economists, and public-health specialists, it centres on five major themes: what is health equity?; health equity and social justice; responsibilities for health; ethical issues in health evaluation; and anthropological perspectives.