The Amount of Health US$1 Million Will Buy| Service or Intervention | Cost per DALY (US$) | DALYs averted per US$1million spent |
| Reducing Under-Five Mortality |
| 1. Improved care of children under 28 days old (including resuscitation of newborns) | 10-400 | 2,500-100,000 |
| 2.1 Expansion of immunization coverage with standard child vaccines | 2-20 | 50,000-500,000 |
| 2.2 Adding vaccines against additional diseases to the standard child immunization program (particularly against haemophilus influenza and hepatitis B) | 40-250 | 4,000-24,000 |
| 3. Switching to the use of combination drugs (ACTs) against malaria where there is resistance to current inexpensive and highly effective drugs (Sub-Saharan Africa) | 8-20 | 50,000-125,000 |
| Preventing and Treating HIV/AIDS |
| 4. Prevention of mother-to-child transmission (ARV-nevirapine- prophylaxis of the mother; breast-feeding substitutes) | 50-200 | 5,000-20,000 |
| 5. STI treatment to interrupt HIV transmission | 10-100 | 10,000-100,000 |
| 6.1 ARV treatment achieving high adherence for a large percentage of patients | 350-500 | 2,000-3,000 |
| 6.2 ARV treatment that achieves high adherence for a small percentage of patients | | because of very limited gains by individual patients and the potential for adverse changes in population behavior, there is the possibility that more life years would be lost than saved |
| Preventing and Treating Noncommunicable Disease |
| 7. Taxation of tobacco products | 3-50 | 20,000-330,000 |
| 8.1 Treatment of acute myocardial infarction (AMI) or heart attacks with an inexpensive set of drugs | 10-25 | 40,000-100,000 |
| 8.2 Treatment of AMI with inexpensive drugs plus streptokinase (costs and DALYs for this are in addition to what would have occurred with inexpensive drugs only) | 600-750 | 1,300-1,600 |
| 9. Lifelong treatment of heart attack and stroke survivors with a daily "polypill" combining 4 or 5 off-patent preventive medications. | 700-1,000 | 1,000-1,400 |
| 10.1 CABG or bypass surgery in specific identifiable high risk cases, such as disease of the left main coronary artery (incremental to 9) | >25,000 | <40 |
| 10.2 Bypass surgery for less severe coronary artery disease (incremental to 9) | very high | very small |
| Other |
| 11. Detection and treatment of cervical cancer | 15-50 | 20,000-60,000 |
| 12. Operation of a basic surgical ward at the district hospital level focusing on trauma, high risk pregnancy, and other common surgically-treatable conditions | 70-250 | 4,000-15,000 |
Sources: DCP2, Chapter 1, table 1.3.
Note: DALYs averted per US$1 million spent on an intervention will vary enormously from country to country and in light of many other factors. This table aims only to provide a very rough sense of how much health can be bought with different interventions and to show that there is huge variation in the amount of different health interventions (or that the same intervention applied in different ways) can provide for the same amount of money.
ACT = artemisinin combination therapy
AMI = acute myocardial infarction
ARV = antiretroviral
CABG = coronary artery bypass graft
STI = sexually transmitted infection
