Essity Hygiene and Health Report 2023–2024: Highlighting the Economic Value of Prevention for Preparedness

Originally published on Essity.com

In light of economic downturns and austerity measures, it is important to focus on the broader value created for society through a total cost calculation, including societal costs. Investment in prevention for preparedness should generate value both for individuals and for society at large. It generates a considerable economic and societal value to health and well-being, which is challenging to quantify.¹ Given the strain on healthcare systems and budgets, it is important to think of long-term benefits available. This requires a value-based approach where the best health outcomes are in focus.

An example of long-term financial planning for healthcare budgets can be a change in attitude to pandemic management. More pandemics are likely to occur in the future², driven by many different factors such as climate change, animal husbandry, and urbanization. Investing in prevention measures can help achieve better health outcomes and reduce infections and pandemics, thus reducing the cost required to manage these. Prevention measures such as education, limiting deforestation, and ensuring access to clean water, sanitation, and hygiene products cost between $10.3 billion and $11.5 billion per year, which is much less than the cost of pandemic preparedness, amounting to around $30.1 billion per year³, both of which are negligible in comparison to Covid-19’s estimated $12.5 trillion cost globally⁴.

In addition to being a cost-effective approach, investing in prevention and more resilient health systems can result in increased productivity and less pressure on social insurance systems. When illness is reduced, less of the labor force is made absent, either through sick leave or for caregiving, leading to increased productivity and economic growth.⁵ It is estimated that workplace absenteeism due to illness costs the European Union 2.5% of its GDP,⁶ and that work- place presenteeism, whereby ill workers go to work despite being ill, also leads to significant costs.⁷

Investing in prevention as a key element for preparedness as laid out in this chapter has broader societal benefits beyond just savings.

Calls for action in prevention for preparedness

• Boost the prevention agenda: For effective prevention of illness, essential hygiene and health measures are crucial. These measures should be integrated into a core prevention agenda to promote health, well-being, and preparedness for pandemics, looming crises like AMR, and other health threats. Boosting preventive actions such as hand hygiene and by prioritizing innovative solutions, in areas where infection prevention is needed, saves lives, keeps people healthy, reduces healthcare costs in the long term and improves productivity. 
   
• Hygiene as a policy area: Hygiene tends to be seen as everyone’s responsibility and lacks a clear home in policy. It is key that clear ownership is established and that the profound societal value that is associated with hygiene practices is recognized. 
   
• Access to basic hygiene products: Concerted efforts are needed to close the gaps in hygiene, cleaning, and sanitation infrastructure, including securing access to clean water, safe, clean, and private hygiene, and sanitation facilities, as well as sustainable surface cleaning. A shift in mindset is needed to prioritize preventative healthcare strategies. 
   
• Up-scaling health systems to include prevention: The Covid-19 pandemic brought to light the need for stronger preparedness in health systems, including increased investments in preventive measures. Concerted efforts are needed to close the gaps in hygiene and cleaning and sanitation infrastructure, including securing access to clean water, safe, clean, and private hygiene, and sanitation facilities, as well as sustainable surface cleaning. Increasing attention is also needed on infection and antimicrobial surveillance in order to enable early intervention. Surgical site infection surveillance is already having a positive impact on reducing infection rates, here, adoption needs to increase. A shift in mindset is needed to prioritize preventative healthcare strategies to address these gaps. 
   
• Invest in knowledge and training: For hygiene and other prevention measures to have lasting impact, there is a need to elevate action on knowledge, skills, implementation and follow up. Making effective and engaging training available to healthcare professionals, cleaning staff and caregivers is key to strengthen prevention measures. This includes investing in educational campaigns, workplace training, and messaging reinforcing best practices, such as proper hand hygiene, wound infection prevention and smart environmental cleaning.

• Invest in preventing AMR within the One Health approach: To make a real impact in the fight against AMR, a multistakeholder approach is needed, where governments, healthcare providers, academia, civil society, and businesses collaborate across all relevant sectors. Working together at local, national and global level to improve infection prevention measures and establish guidelines, supported by education and training, and to emphasize the cost-effectiveness of prevention is key.

  A relevant example is antimicrobial stewardship in wound care, which should be incorporated in care standards and practices, included in trainings for care givers and prioritized in financing and usage.

• Mobilize partnerships to step up prevention and innovation for future health needs: To enable technical development, innovation, digital solutions, and research that aims to optimize the use of resources in prevention and preparedness, there is a need to step up collaboration across sectors and mobilize partnerships. To effectively combat challenges like AMR and HAIs, it is crucial for healthcare institutions to not only address immediate needs but also to invest in long-term solutions based on prevention. To further prevent AMR, there is a need to ensure that AMR forms an integral part of wider healthcare training.

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¹López-Casasnovas G. (2005). Health and economic growth : findings and policy implications. MIT Press.

²GAVI (2022) New study suggests risk of extreme pandemics like COVID-19 could increase threefold in coming decades https://www.gavi.org/vaccineswork/new-study-suggests-risk-extreme-pandemics-Covid-19-could-increase-threefold-coming

³World Bank Group (2022) Putting Pandemics Behind Us: Investing in One Health to Reduce Risks of Emerging Infectious Diseases.” Washington, DC. https://openknowledge.worldbank.org/server/api/core/bitstreams/956a58be-ddd8-572f-8aac-df5ab453d7b2/content

⁴Reuters. (2022, January 20). IMF sees cost of COVID pandemic rising beyond $12.5 trillion estimate. Reuters. https://www.reuters.com/ business/imf-sees-cost-covid-pandemic-rising-beyond-125-trillion-estimate-2022-01-20/

⁵Strömberg, C., Aboagye, E., Hagberg, J., Bergström, G., & Lohela-Karlsson, M. (2017). Estimating the Effect and Economic Impact of Absenteeism, Presenteeism, and Work Environment-Related Problems on Reductions in Productivity from a Managerial Perspective. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 20(8), 1058–1064.

⁶Human Capital Hub (2022). Absenteeism in the workplace: Impact, causes, and policies. Human Capital Hub. https://www.thehumanca- pitalhub.com/articles/absenteeism-in-the-workplace-impact-causes-and-policies

⁷Strömberg, C., Aboagye, E., Hagberg, J., Bergström, G., & Lohela-Karlsson, M. (2017). Estimating the Effect and Economic Impact of Absenteeism, Presenteeism, and Work Environment-Related Problems on Reductions in Productivity from a Managerial Perspective. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 20(8), 1058–1064.