This year's mid-term election in the United States has been this nation's most expensive yet, costing an estimated $4 billion. Compared to national and state budgets, it's a small amount, but that kind of money can still make a huge impact on issues that affect our health, well-being and security.
For those who would argue democracy has a price and absurdly inflated campaign finance is part of the cost of free and fair elections, consider this: the United Kingdom spent an estimated £113,225,271 (around $173 million in US dollars at the time) on parliamentary elections in 2010.
Also in 2010, Australia held its House of Representatives and half-senate elections, with a price tag of $161,342,861 Australian dollars or about $143.5 million U.S. dollars at the time. The cost of the U.S. mid-term in the same year? Over $3.6 billion. With a B. These figures also point to the fallacy in equating money with fair process: both the U.K. and Australia out-rank the United States in a number of published democracy and electoral freedom indices.
So, imagine for a minute that all those corporate donations, Super PACs, individual contributions and public money wasn't spent on persuading us why one politician is better than another -- what could $4 billion buy? Here are three ideas at the top of our wish list:
1) Controlling Ebola AND Eradicating Measles:
With seven confirmed cases in the United States by the time Election Day rolled around, Ebola was quickly politicized and used in campaigning. To date, the U.S. has committed an impressive $377 million towards the response effort, which the United Nations estimates will cost, in total, just over $1 billion over the next six months. With mid-term money, we could have funded the entire international relief effort almost four times over. Moreover, the U.S. Ebola pledge is a mere 9 percent of the amount which we willingly spent on the mid-terms - that's a pretty clear indication of priorities.
If we chose to focus on the next six months of Ebola response, we'd have a handy $3 billion or so left over, which could be used for a longer term, yet extremely high impact, issue: eradicating measles. The upper range of the estimate for eliminating measles entirely from our planet is $3.1 billion -- easily achievable with our midterm budget. More to the point, the returns on this investment are staggering - saving up to 350 million disability-adjusted life years by 2050, for a cost of approximately $7.8 billion.
2) Honor the U.S. Commitment to the Global Fund:
While tackling a single disease issue is laudable, what about providing funding support to the international institutions that tackle, holistically, the most pressing infectious disease challenges? Coincidentally, $4 billion is the amount the Obama administration pledged to support the Global Fund to Fight AIDS, Tuberculosis and Malaria for the period 2011-2013, and roughly equal to the contributions committed for 2014-2016. In the wake of the 2011 budget cuts, the Administration considered reneging on this promise.
The threat of reduced funding forced the Global Fund to cease providing new grants, denying anti-retroviral therapies, antibiotics, and bednets to those who needed them most. A steady and reliable funding base is critical for organizations like the Global Fund to support the kind of long-term projects that have the most substantial impacts. The U.S. has, commendably, been the single largest contributor to the Global Fund to date - this commitment must be sustained, and $4 billion is a small price to pay.
3) Build Foundational Health Systems in Every Country:
You could argue even the Global Fund focuses too narrowly on a sub-set of diseases; after all, it wouldn't have prevented the emergence of the Ebola outbreak. So let's get back to basics -- how much would it cost to build the essential, foundational public health and veterinary infrastructure that would enable all countries of the world to prevent, detect, and respond to disease outbreaks? Thankfully, the World Bank has made those calculations, and estimates that even under a scenario of high disease transmission and risk, all it would take to develop and sustain these permanent systems is up to $3.4 billion annually. The pay-off: An incredible $37 billion saved in reduced disease incidence and prevented pandemics.
We paid $4 billion for the 2014 mid-term elections, and what did we get? 435 Representatives in the House, 36 Senators and 36 Governors.
Doesn't seem like a great deal, given the alternatives.
Claire Standley and Sarah Kornblet are both senior researchers for the Global Health Security Program at Milken Institute School of Public Health at the George Washington University.