The Covid-19 pandemic has posed governments with many ethical questions regarding lockdowns, vaccine prioritization, and how to evaluate health-related interventions that can have different health and socioeconomic spillover effects throughout the population.
Traditional evaluation methods, such as cost-effectiveness analysis (CEA) and benefit-cost analysis (BCA), are poorly suited to deal with the complexity of these issues. Cost-effectiveness analysis typically takes a health-centric approach focusing on just two sets of benefits: the changes in mortality and morbidity and the healthcare cost savings. On the other hand, Benefit-cost analysis can handle differential socioeconomic benefits across different units of health through the definition of individual-specific willingness-to-pay measures. However, it tends to inflate the benefits accruing to wealthy individuals relative to similar benefits accruing to their less affluent counterparts because the willingness to pay depends on the ability to pay.
This social welfare function (SWF) analysis method measures an intervention’s joint health and non-health effects on individual well-being. It aggregates individual well-being impacts to obtain an overall measure of the value of the intervention. The approach accounts for the distribution of policy impacts across the population and the correlation with background inequalities. It is more attractive than traditional methods such as benefit-cost analysis and cost-effectiveness analysis and more consistent with the idea that equity and justice matter in policy evaluation.
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