Help Us Build the OHS Prevention Ledger

We are developing Issue 002 of the One Health Security Monthly Review, provisionally titled The Economics of Prevention — and we would genuinely welcome ideas, criticism, examples and contributions from people working across public health, animal health, biosecurity, economics, policy, surveillance and preparedness.

The central question is simple: how do we make the economic case for preventing biological threats before the crisis happens?

Prevention is difficult to value because success often looks like nothing happening. An outbreak that never occurs does not generate hospital admissions, emergency-response costs, livestock losses, business interruption or political attention. The benefits exist largely as avoided outcomes — which makes prevention easy to underfund and difficult to defend against more visible short-term priorities.

What we want to examine

For Issue 002, we want to approach that problem more rigorously. We are particularly interested in how prevention and preparedness investments should be valued, how to distinguish measured benefits from modelled counterfactuals, methods for estimating avoided health, agricultural and economic losses, the value of surveillance, vaccination, diagnostics and biosecurity capability, how uncertainty should be communicated, examples where prevention investment demonstrably changed outcomes, examples where failure to invest early created substantially larger downstream costs, and where conventional cost-benefit analysis does — and does not — work well for biological risk.

The OHS Prevention Ledger

We are also developing an experimental resource for the Review: the OHS Prevention Ledger. The idea is to create a transparent framework that traces prevention investment through to the capability it creates, the risk that capability reduces, and the outcomes potentially avoided as a result. Rather than produce a single headline “return on investment” figure, the Ledger would show the assumptions, evidence quality, uncertainty and counterfactual reasoning behind each estimate.

A worked example might ask: if £1 million is invested in surveillance, what additional capability does that actually purchase? How might that change detection time or outbreak size? What health, agricultural or economic consequences might therefore be avoided? And how confident can we reasonably be in those estimates?

We want the tool to be useful, but also intellectually honest — so we are especially interested in people willing to challenge it. What are we missing? Which methods should we use? What should never be reduced to a monetary value? How should uncertainty be represented? What real-world prevention investments would make useful worked examples? And perhaps most importantly: what evidence would make you trust, or distrust, an economic claim about prevention?

How to contribute

If you work in public health, veterinary medicine, epidemiology, economics, health economics, agriculture, insurance, risk analysis, emergency management, biosecurity, modelling, surveillance or a related field, we would be very pleased to hear from you. You do not need to submit a formal paper — a dataset, case study, methodological suggestion, criticism, useful reference, counter-example or simply a thoughtful disagreement could all help shape the issue.

Issue 002, The Economics of Prevention, will explore not only what prevention costs, but how we decide what it is worth. Thoughts, examples and constructive criticism are very welcome — get in touch via our contact page.

A case study to start with

If you want to see this problem in practice before contributing, our analysis Drug Development Follows Markets. Biological Risk Does Not. is a useful place to start — it looks at the FDA’s new veterinary medicines strategy through exactly this lens: what happens when a capability society needs does not have a market large enough to justify building it.