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AJPH First Look, published online ahead of print Aug 29, 2007
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October 2007, Vol 97, No. 10 | American Journal of Public Health 1733
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2007.116772

LETTER

LEROY ET AL. RESPOND

Jef L. Leroy, PhD, MSc, Jean-Pierre Habicht, MD, PhD, MPH, Gretel Pelto, PhD, MA and Stefano M. Bertozzi, MD, PhD

Jef L. Leroy and Stefano M. Bertozzi are with the Mexican National Institute of Public Health (Instituto Nacional de Salud Publica), Cuernavaca, Mexico. Stefano M. Bertozzi is also with the Center for Economics Research and Education, Mexico City, and the University of California, Berkeley. Jean-Pierre Habicht and Gretel Pelto are with the Division of Nutritional Sciences, Cornell University, Ithaca, NY.

Correspondence: Requests for reprints should be sent to Jef L. Leroy, PhD, MSc, Instituto Nacional de Salud Publica, Avenida Universidad No. 655, Col. Sta. María Ahuacatitlán, Cuernavaca, Morelos, Mexico 62508 (e-mail: jleroy{at}correo.insp.mx).

We read Woolf and Johnson’s letter with great interest. The similarity of the findings for developing countries and the United States is impressive,1 as they reflect the influence of the shared assumptions in the research community that lead to low investments in research to improve the fidelity (quality) of health care delivery and utilization.

We have a slight correction to make to their letter. Our research shows that 6 million (not 4 million) lives can be saved by improved delivery and utilization without any additional or improved technology. In addition, 2 million children could be saved by new technology (for which current technology is inadequate) if the new technology were delivered and utilized at present rates, and 2 million could be saved by improving both technology and delivery and utilization. Thus, the prevention of 80% of child deaths requires improving delivery and utilization, which nevertheless only receives 3% of research funding.2

We do not believe that resource allocation needs to be a zero-sum game, that is, that existing funds must be used either for research on delivery and utilization or for development of new technology. We argued in our study for more funding for the former relative to the latter, not that funds be taken away from the latter to fund the former.

We hope that the empirical evidence in both studies will help to persuade the research community that greater research attention to issues of delivery and utilization is essential if the benefits of currently available technology are to be realized.

Accepted for publication April 25, 2007.

References

1. Woolf SH, Johnson RE. The break-even point: when medical advances are less important than improving the fidelity with which they are delivered. Ann Fam Med. 2005;3:545–552.[Abstract/Free Full Text]

2. Leroy JL, Habicht JP, Pelto G, Bertozzi SM. Current priorities in health research funding and lack of impact on the number of child deaths per year. Am J Public Health. 2007;97:219–223.[Abstract/Free Full Text]





This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
AJPH.2007.116772v1
97/10/1733    most recent
Right arrow Submit a response
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Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
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Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
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Right arrow Get other permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Leroy, J. L.
Right arrow Articles by Bertozzi, S. M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Leroy, J. L.
Right arrow Articles by Bertozzi, S. M.
Related Collections
Right arrow Other Maternal and Infant Health
Right arrow Nutrition/Food
Right arrow Other Child and Adolescent Health
Right arrow Mortality

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