A Cost–Benefit Approach
Chapter 43: Conclusions II: Using CBA to Set Priorities for HIV
Critics of CBA, who wish to avoid its use on the grounds that willingness to pay does not allow for ability to pay, risk the proverbial problem of “throwing out the baby with the bathwater”. So the strengths of using WTP are ignored by the critics. This is unfortunate as much of the politics of HIV/AIDS involves activists thinking that they have to get organized and petition governments in order that a particular perspective be incorporated in the HIV/AIDS decision-making process when, in fact, every perspective would automatically be included if a cost–benefit framework using WTP were used. We have throughout the book emphasized that CBA tries to include all the effects of an intervention by estimating the WTP of everyone who is affected by it. The main task in this chapter is to spell out some of the implications of this all-inclusive property of CBA. As this is the final chapter, the summary and conclusions section briefly sums up what this book has tried to achieve. WILLINGNESS TO PAY AND SOCIAL INCLUSIVENESS WTP records individual preferences and the intensity of those preferences. When we say that the net benefits of a project are the sum of the WTP of all those affected, we are stating that, no matter whether these net benefits are positive or negative, we have included everyone’s preferences in the evaluation and these preferences will determine the decision outcome. Only if decisions are not made on the basis of WTP do activist groups need to...
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