Although TETD did not result in substantial savings to SSA, the evaluation suggested that participant benefits might have resulted in a net societal benefit.
In sub-Saharan Africa (SSA), substantial reductions in childhood mortality, through the introduction of life saving antiretroviral therapy and other preventative measures against communicable diseases are credited with the observed increases in life expectancy [ 3].
These aspects can explain the substantial lower rate of SSA in their work compared with our study.
The research agenda required for academic institutions to bring improvements to the healthcare system in SSA is substantial.
GW, JW, RM, RA, SM, KKM, KKT, SSA made substantial contributions to conception and design of the study and participated in the writing of the manuscript.
Even if we assume the coefficients are unbiased estimates of the additive effects of exogenous changes to the two access measures, the estimated effects of these substantial changes in access on SSA outcomes would be modest relative to the number of annual SSDI applications and awards.
Furthermore, available data for 23/34 SSA countries suggest substantial inequity (GINI coefficient ≥0.4; the GINI coefficient ranges from 0, perfect equity, to 1, absolute inequity, with a value of 0.4 being considered the international alert line)), highlighting that the poor may benefit least from health investments, thus limiting overall health gains.
Further, despite the widespread availability of free HIV testing in SSA, and significant increases in the number of clients presenting for free vs. fee-based HCT [2], substantial numbers of people do not test.
Globally, development of biotechnology has been a factor in increasing health and life expectancy in SSA, so we argue that a substantial investment in this area will produce significant benefit for SSA.
In Ethiopia, Malawi and Namibia the decline in under-five child mortality has been substantial despite meagre resources, while in other SSA countries it has remained the same.
