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The World Bank is publishing nine volumes of Disease Control Priorities, 3rd edition (DCP3) between 2015 and 2018. Volume 9, Improving Health and Reducing Poverty, summarises the main messages from all the volumes and contains cross-cutting analyses. This Review draws on all nine volumes to convey conclusions. The analysis in DCP3 is built around 21 essential packages that were developed in the nine volumes. Each essential package addresses the concerns of a major professional community (eg, child health or surgery) and contains a mix of intersectoral policies and health-sector interventions. 71 intersectoral prevention policies were identified in total, 29 of which are priorities for early introduction. Interventions within the health sector were grouped onto five platforms (population based, community level, health centre, first-level hospital, and referral hospital). DCP3 defines a model concept of essential universal health coverage (EUHC) with 218 interventions that provides a starting point for country-specific analysis of priorities. Assuming steady-state implementation by 2030, EUHC in lower-middle-income countries would reduce premature deaths by an estimated 4·2 million per year. Estimated total costs prove substantial: about 9·1% of (current) gross national income (GNI) in low-income countries and 5·2% of GNI in lower-middle-income countries. Financing provision of continuing intervention against chronic conditions accounts for about half of estimated incremental costs. For lower-middle-income countries, the mortality reduction from implementing the EUHC can only reach about half the mortality reduction in non-communicable diseases called for by the Sustainable Development Goals. Full achievement will require increased investment or sustained intersectoral action, and actions by finance ministries to tax smoking and polluting emissions and to reduce or eliminate (often large) subsidies on fossil fuels appear of central importance. DCP3 is intended to be a model starting point for analyses at the country level, but country-specific cost structures, epidemiological needs, and national priorities will generally lead to definitions of EUHC that differ from country to country and from the model in this Review. DCP3 is particularly relevant as achievement of EUHC relies increasingly on greater domestic finance, with global developmental assistance in health focusing more on global public goods. In addition to assessing effects on mortality, DCP3 looked at outcomes of EUHC not encompassed by the disability-adjusted life-year metric and related cost-effectiveness analyses. The other objectives included financial protection (potentially better provided upstream by keeping people out of the hospital rather than downstream by paying their hospital bills for them), stillbirths averted, palliative care, contraception, and child physical and intellectual growth. The first 1000 days after conception are highly important for child development, but the next 7000 days are likewise important and often neglected.

Very often, we’re uncertain about what we ought, morally, to do. We don’t know how to weigh the interests of animals against humans, or how strong our duties are to improve the lives of distant strangers, or how to think about the ethics of bringing new people into existence. But we still need to act. So how should we make decisions in the face of such uncertainty? Though economists and philosophers have extensively studied the issue of decision-making in the face of uncertainty about matters of fact, the question of decision-making given fundamental moral uncertainty has been neglected. In this book, philosophers William MacAskill, Krister Bykvist and Toby Ord try to fill this gap. They argue that there are distinctive norms that govern how one ought to make decisions given moral uncertainty. They then defend an information-sensitive account of how to make such decisions according to which the correct way to act in the face of moral uncertainty depends on whether the moral theories in which one has credence are merely ordinal, cardinal, or both cardinal and intertheoretically comparable. They tackle the problem of how to make intertheoretic comparisons, discussing several novel potential solutions. Finally, they discuss implications of their view for metaethics and practical ethics, and show how their account can shed light on the value of moral enquiry.

It is often claimed that from the moment of conception embryos have the same moral status as adult humans. This claim plays a central role in many arguments against abortion, in vitro fertilization, and stem cell research. In what follows, I show that this claim leads directly to an unexpected and unwelcome conclusion: that natural embryo loss is one of the greatest problems of our time and that we must do almost everything in our power to prevent it. I examine the responses available to those who hold that embryos have full moral status and conclude that they cannot avoid the force of this argument without giving up this key claim.

Some risks have extremely high stakes. For example, a worldwide pandemic or asteroid impact could potentially kill more than a billion people. Comfortingly, scientific calculations often put very low probabilities on the occurrence of such catastrophes. In this paper, we argue that there are important new methodological problems which arise when assessing global catastrophic risks and we focus on a problem regarding probability estimation. When an expert provides a calculation of the probability of an outcome, they are really providing the probability of the outcome occurring, given that their argument is watertight. However, their argument may fail for a number of reasons such as a flaw in the underlying theory, a flaw in the modeling of the problem, or a mistake in the calculations. If the probability estimate given by an argument is dwarfed by the chance that the argument itself is flawed, then the estimate is suspect. We develop this idea formally, explaining how it differs from the related distinctions of model and parameter uncertainty. Using the risk estimates from the Large Hadron Collider as a test case, we show how serious the problem can be when it comes to catastrophic risks and how best to address it.

Getting good value for the money with scarce resources is a substantial moral issue for global health. In this chapter, Toby Ord explores the moral relevance of cost-effectiveness, a major tool for capturing the relationship between resources and outcomes, by illustrating what is lost in moral terms for global health when cost-effectiveness is ignored. For example, the least effective HIV/AIDS intervention produces less than 0.1 per cent of the value of the most effective. In practical terms, this can mean hundreds, thousands, or millions of additional deaths due to a failure to prioritize. Ultimately, the author suggests that creating an active process of reviewing and analyzing global health interventions to deliver the bulk of global health funds to the very best.

We introduce new theoretical insights into two-population asymmetric games allowing for an elegant symmetric decomposition into two single population symmetric games. Specifically, we show how an asymmetric bimatrix game (A,B) can be decomposed into its symmetric counterparts by envisioning and investigating the payoff tables (A and B) that constitute the asymmetric game, as two independent, single population, symmetric games. We reveal several surprising formal relationships between an asymmetric two-population game and its symmetric single population counterparts, which facilitate a convenient analysis of the original asymmetric game due to the dimensionality reduction of the decomposition. The main finding reveals that if (x,y) is a Nash equilibrium of an asymmetric game (A,B), this implies that y is a Nash equilibrium of the symmetric counterpart game determined by payoff table A, and x is a Nash equilibrium of the symmetric counterpart game determined by payoff table B. Also the reverse holds and combinations of Nash equilibria of the counterpart games form Nash equilibria of the asymmetric game. We illustrate how these formal relationships aid in identifying and analysing the Nash structure of asymmetric games, by examining the evolutionary dynamics of the simpler counterpart games in several canonical examples.

This paper argues in favor of a particular account of decision-making under normative uncertainty: that, when it is possible to do so, one should maximize expected choice-worthiness. Though this position has been often suggested in the literature and is often taken to be the 'default' view, it has so far received little in the way of positive argument in its favor. After dealing with some preliminaries and giving the basic motivation for taking normative uncertainty into account in our decisionmaking, we consider and provide new arguments against two rival accounts that have been offered-the accounts that we call 'My Favorite Theory' and 'My Favorite Option'. We then give a novel argument for comparativism-the view that, under normative uncertainty, one should take into account both probabilities of different theories and magnitudes of choice-worthiness. Finally, we further argue in favor of maximizing expected choice-worthiness and consider and respond to five objections.