It is increasingly recognised that health has complex but pervasive linkages to individual wellbeing and to the viability of communities across the life cycle. After many decades of medical innovation, powerful knowledge resources are available to further transform population health.

This program forms part of the research by the Victoria Institute of Strategic Economic Studies (VISES). Its focus is on developing and applying better methods for assessing the full economic and social benefits of large-scale programs of health intervention.

We do this for individual countries and across groups of countries, and work with major partners to apply these methods to measure the returns to investment in such interventions.

Research areas

Investment Analysis: Life Stage & Disease Areas

We have developed a set of international assessment tools in health and education, to estimate the economic and social impact of health and education interventions. Other models developed estimate the economic and social monetary value of the benefits of intervention outcomes. Resulting benefit-cost ratios demonstrated significant value for developing countries investing in health and education.

International studies commissioned by the WHO, UNICEF, the UNFPA, and the US Chamber of Commerce applied these quantitative assessment tools to a range of health and education programs, including child and maternal health and adolescent well-being, and disease areas including mental health and cardiovascular disease.

Our new and current projects include:

  • an adolescent wellbeing investment case study for the Partnership for Maternal, Newborn and Child Health, the world’s largest alliance for women’s, children’s and adolescents’ health and well-being, with +1,300 partner organizations, hosted by the World Health Organization. The study was in preparation for the Global Forum for Adolescents held on 11–12 October 2023, which brought together youth and adolescents, advocates and global decision-makers. It collates current knowledge on the case for investing in adolescent wellbeing and includes modelling to estimate the benefit-cost ratios for a selected set of health, education and related interventions. The report will be available in late 2023.
  • an investment case for the WHO Regional Office for the Eastern Mediterranean to support the repurposing of the of polio teams’ assets to support public health teams to also address other vaccine preventable diseases. 
  • a study for the Fred Hollows Foundation on women’s eye health, developing an epidemiological and economic model of interventions to estimate the return on investment from programs that improve visual impairment due to cataracts and refractive error. Women have been interviewed in Laos about their experiences of the impact of cataract surgery, with others planned in Kenya and Pakistan.
  • a study to undertake an investment case study on HPV vaccination in Indonesia for Merck Sharp and Dohme (Australia) and provide policy recommendations on the national rolling out of HPV vaccination there.

Vaccinations against human papillomavirus (HPV)

We recently finished a study for UNFPA Vietnam on the benefits of investing in vaccinations against human papillomavirus (HPV) and cervical cancer screening for adolescent girls and women.

The study provides strong evidence to support the efforts of the Ministry of Health of Vietnam and other agencies to scale up an human papilloma virus (HPV) vaccination program in Vietnam for girls and women. The study shows that a vaccination program will return between around 5 and 11 times its cost in economic benefits, and between 8 and 20 times its cost in combined economic and social benefits.

The study was undertaken in collaboration with the National Institute of Hygiene and Epidemiology (NIHE) under the Ministry of Health and Daffodil Institute in Australia. Dr Kim Sweeny attended the launch on 10 May 2023 in Hanoi.

Investment case study for the World Health Organisation (WHO)

The COVID crisis illustrated how important the WHO is for world health, but also how inadequately it is funded for this task. In 2022, we carried out an investment case for the WHO to increase its funding levels.

We estimated the economic and social return to investing in WHO, by modelling the global benefits likely to arise from over 100 interventions in which WHO will be involved, estimating the share of those benefits attributable to WHO, and calculating a benefit-cost ratio of the attributable benefits to total expenditure by WHO over the next decade.

The modelling showed that for every dollar spent by the member states on WHO programs, the return is at least $35. The study results supported a WHO report A Health Return: Investment Case for a Sustainably Finance WHO.

Reducing road traffic injuries among adolescents

In 2021, the research team partnered with the Murdoch Children’s Research Institute, a charity dedicated to research into children's health, to developed the global investment case to reduce road traffic injuries among adolescents for the FIA Foundation (London).

It was found that almost 12 million serious injuries to children and youth can be prevented between now and 2050 if proven road safety interventions are implemented across 77 low- and middle-income countries. 

Read the media release

The cost of not investing in adolescents' education in Syria

A project for UNICEF in collaboration with the UNFPA on adolescents' education and the cost of not investing in their education in Syria was finalised in October 2022.

The study found that the estimated economic return is $42 for $1 invested in the recovery program, including benefits to 2050. UNICEF Syria produced a brief (in English and in Arabic) from the results of the project.

The study results will be presented to the Ministry of Education (Syria) and the Global Forum for Education in June 2023.

Further studies

An investment case study for the UNICEF on adolescents in Burundi looked to identify a package of interventions in health and education ensuring the best return on investment, in terms of economic and human development, and national income growth. 

Studies are also carried out for industry bodies and consulting companies. A 2021 study for Shawview Consulting modelled the economic productivity of vaccination and other societal benefits to Australia from Australia’s National Immunisation Program.

We investigated investing in adolescents in India estimating the costs and benefits of interventions that promote health and socio-economic development ( Selvaraj et al. 2020; Rasmussen et al. 2021).

A study of adolescent wellbeing included an analysis of the economic impact of the intergenerational effects of early marriage on children’s education was published in Nature (Patton et al. 2018).

Results of a 2017 UNFPA global study on adolescent wellbeing were published in The Lancet (2017) and the supporting papers in the Journal of Adolescent Health (2019).

Investment Cases in General

Sheehan, P., Rasmussen, B., Sweeny, K., Maharaj, N. and Symons, J. 2022, WHO Investment Case 2.0: Technical Report, March, Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne.

Rasmussen, B., Sheehan, P., Symons, J., Maharah, N., Welsh, A. and Kumnick, M. 2022, Syria Education and Development Investment Case: Economic, Social and Psychological Costs and Risks Resulting from Not Investing in Education Systems in Syria, Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne.

Symons, J., Rasmussen, B. and Maharaj, N. 2022, Proposed Interventions for Modelling Formal Education, VISES Project Working Paper 2022–1, Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne.

Shawview Consulting 2021, Valuing Vaccines: Ensuring Australia’s Access to Vaccines Today, December, Sydney.

Life Stage: Maternal & Child Health

Nguyen, T., Sweeny, K., et al. 2019, ‘Protocol for an economic evaluation alongside a cluster randomised controlled trial: Cost-effectiveness of Learning Clubs, a multicomponent intervention to improve women's health and infant's health and development in Vietnam’, BMJ Open, 9(12).

Stenberg, K., Sweeny, K., Axelson, H. and Sheehan, P. 2017, ‘Investing in the continuum of care for RMNCH’, in D. Jamison, et al. (eds), Disease Control Priorities in Developing Countries (DCP3), 3rd edn, Volume 2, The Continuum of Reproductive, Maternal, Newborn and Child Health, chap. 15.

Stenberg, K., Axelson, H., Sheehan, P., Anderson, I., Gülmezoglu, A.M., Temmerman, M., Mason, E., Friedman, H.S., Bhutta, Z.A., Lawn, J.E., Sweeny, K., Tulloch, J., Hansen, P., Chopra, M., Gupta, A., Vogel, J.P., Ostergren, M., Rasmussen, B., Levin, C., Boyle, C., Kuruvilla, S., Koblinsky, M., Walker, N., de Francisco, A., Novcic, N., Presern, C., Jamison, D. and Bustreo, F. 2014, ‘Advancing social and economic development by investing in women's and children's health: A new global investment framework’, Lancet, 383, 1333–1354.

Life Stage: Adolescent Health & Wellbeing

Symons, J. and Sweeny, K. 2022, Development of the Investment Case to Reduce Road Traffic Injuries among Adolescents, Final Report to FIA Foundation, London.

Rasmussen, B., Maharaj, N., Karan, A., Symons, J., Selvaraj, S., Kumar, R., Sheehan, P. and Kumnick, M. 2021, Evaluating interventions to reduce child marriage in India, Journal of Global Health Reports, vol. 5, e2021044.

Selvaraj, S., Chaudhuri, C., Karan, A., Sheehan, P., Rasmussen, B. et al. 2020, The Potential Benefits and Costs of Interventions in Adolescent Well-being in India: Evidence from Return on Investment Models, Research Paper, Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne.

Rasmussen, B., Sheehan, P., Sweeny, K., Symons, J. and Maharah, N. 2019, Adolescent Investment Case Burundi: Estimating the Impacts of Social Sector Investments for Adolescents, UNICEF Burundi, Bujumbura.

Sweeny, K., Friedman, H.S., Sheehan, P., Fridman, M. and Shi, H. 2019, ‘A health-system based investment case for adolescent health’, Journal of Adolescent Health, 65, S8-S15.

Sheehan, P. and Shi, H. 2019, ‘Employment and productivity benefits of enhanced educational outcomes: A preliminary modelling approach’, Journal of Adolescent Health, 65, S44-S51.

Symons, J., Howard, E., Sweeny, K., Kumnick, M. and Sheehan, P. 2019, ‘Reduced road traffic injuries for young people: A preliminary investment analysis’, Journal of Adolescent Health, 65, S34-S43.

Patton, G.C., Olsson, C.A., Skirbekk, V., Saffery, R., Wlodek, M.E., Azzopardi, P.S., Stonawski, M., Rasmussen, B., Spry, E., Francis, K., Bhutta, Z.A., Kassebaum, N.J., Mokdad, A.H., Murray, C.J.L., Prentice, A.M., Reavley, N., Sheehan, P., Sweeny, K., Viner, R.M., Sawyer, S.M. 2018, ‘Adolescence and the next generation’, Nature, 554, 458-467, https://www.nature.com/articles/nature25759

Sheehan, P., Sweeny, K., Rasmussen, B., Wils, A., Friedman, H.S., Mahon, J., Patton, G.C., Sawyer, S.M., Howard, E., Symons, J., Stenberg, K., Chalasani, S., Maharaj, N., Reavley, N., Shi, H., Fridman, M., Welsh, A., Nsofor, E. and Laski, L. 2017, ‘Building the foundations for sustainable development: A case for global investment in the capabilities of adolescents’, Lancet, 390, 1792-1806.

Disease Areas: Non-Communicable Diseases

Qin, J., Zhang, Y/, Fridman, M., Sweeny, K., Zhang, L., Lin, C., et al. 2021, ‘The role of the Basic Public Health Service program in the control of hypertension in China: Results from a cross-sectional health service interview survey’, PLoS ONE, 16(6), e0217185, https://doi.org/10.1371/journal.pone.0217185

Bertram, M.Y., Sweeny, K., Lauer, J.A., Chisholm, D., Sheehan, P., Rasmussen, B., et al. 2018, ‘Investing in non-communicable diseases: An estimation of the return on investment for prevention and treatment services’, Lancet, 391, 2071–2078.

Zhang, Y., Liu, F., Pu, L., Qin, J. and Sweeny, K. 2018, ‘Effectiveness prediction of community‐based hypertension management in China: An analysis based on risk prediction models’, Chinese Genera Practice, 21(17), 2082–2087.

Disease Areas: Mental Health

Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., et al. 2016, ‘Scaling-up treatment of depression and anxiety: A global return on investment analysis’, Lancet Psychiatry, 3, 415-424.

Sweeny, K. and Shi, H. 2016, ‘The Economic Cost of Serious Mental Illness and Comorbidities in Australia and New Zealand’, Report prepared for The Royal Australian and New Zealand College of Psychiatrists, VISES, Victoria University, Melbourne.

Productivity & Health

A multi-country study for the US Chamber of Commerce’s (USCC) Global Initiative on Health and the Economy (GIHE) uses a rate of return methodology to estimate the costs and benefits to investing in health interventions to improve health outcomes for the working adults. The study focuses on cardiovascular disease, diabetes and mental illness and covers about 30 countries. It follows earlier work for the Chamber, the APEC Life Sciences Innovation Forum (LSIF) and the APEC Business Advisory Committee on the economic cost of ill health on workforce productivity.

Bruce Rasmussen was Co-Chair (Academic) of LSIF, where he worked with the LSIF executive board to establish a dialogue in innovative health financing mechanisms with APEC senior finance officials and their Finance Ministers. 

Rasmussen, B., Sweeny, K., Welsh, A., Kumnick, M., Reeve, M. and Dayal, P. 2020, Increasing Social and Economic Benefits Globally: Rates of Return on Health Investments, USCC and Victoria University, Washington DC.

Rasmussen, B., Sweeny, K., Maharaj, N. and Welsh, A. 2018, Our Health Our Wealth: The Impact of Ill Health on Retirement Savings in Australian, Report to The McKell Institute, VISES, Melbourne.

Rasmussen, B., Sweeny, K. and Sheehan, P. 2016, Health and the Economy: The Impact of Wellness on Workforce Productivity in Global Markets, Report to the U.S. Chamber of Commerce’s Global Initiative on Health and Economy, Washington, DC, April, 28 pp.

Rasmussen, B., Sweeny, K. and Sheehan, P. 2015, Cost of Early Retirement Due to Ill Health, Report to the APEC Business Advisory Council and US Chamber of Commerce, VISES, Melbourne, July.

Rasmussen, B., Sweeny, K. and Sheehan, P. 2015, Cost of Early Retirement Due to Ill Health: Phase II Countries, Report to the APEC Business Advisory Council and US Chamber of Commerce, VISES, Melbourne, October.

Rasmussen, B., Sweeny, K. and Sheehan, P. 2015, Economic Costs of Absenteeism, Presenteeism and Early Retirement Due to Ill Health: A Focus on Brazil, Report to the Brazil-U.S. Business Council, the US Chamber of Commerce and the APEC Business Advisory Council, VISES, Victoria University, Melbourne.

Role of Women

The UNFPA publishes yearly a report on the State of the World Population. In 2020, it was dedicated to the rights of women. The age of marriage is fundamental to female empowerment. Child marriage has consequences not only on the basic rights of these women, but on economic, social and demographic effects for regions where the practice is widespread. We contributed material for the chapter on the effects of child marriage, its causes and the costs of the interventions to eliminate the incidence of child marriage. 

The UNFPA also commissioned an estimation of the cost of ‘eliminating’ child marriage by 2030 in accordance with the UN Sustainable Development Goals. We collaborated with John Hopkins University, University of Washington and Avenir Health (presented at the International Conference on Population and Development in Nairobi, hosted by the UN, Kenyan and Danish Governments – November 2019). This work was subsequently extended to estimate not only the costs, but also the substantial economic benefits of eliminating child marriage by 2030.

Part of a study of adolescent wellbeing (see above) for the UN Population Fund included analysis of the economic impact of child marriage and has been published in the Journal of Adolescent Health (Rasmussen et al. 2019).

Other research for the UNFPA, in partnership with the Public Health Foundation of India, on investing in adolescents in India, in particular interventions to eliminate child marriage, was published in the Journal of Global Health Reports (Rasmussen et al. 2021).

Rasmussen, B., Maharaj, N., Karan, A., Symons, J., Selveraj, S., Kumar, R., Sheehan, P. and Kumnick, M. 2021, ‘Evaluating interventions to reduce child marriage in India’, Journal of Global Health Reports, vol. 5, e2021044.

Rasmussen, B., Symons, J. and Maharaj, M. and Madonia, K. 2020, ‘Promised, given, traded, sold’, in UNFPA, State of the World Population: Against My Will, New York, pp. 94-113.

Rasmussen, B., Symons, J. and Maharaj, N. 2020, ‘Cost of ending child marriage’, in Johns Hopkins University, Avenir Health, Victoria University, Institute of Health, Metrics and Evaluation and UNFPA, Costing the Three Transformative Results, UNFPA, New York, chap. 4.

Rasmussen, B., Maharaj, N., Sheehan, P. and Friedman, H. 2019, ‘Evaluating the employment benefits of education and targeted interventions to reduce child marriage’, Journal of Adolescent Health, 65, no. 1, S16-S24.

Research projects

  • PMNCH/WHO: Investment case in adolescent wellbeing
  • WHO EMRO: repurposing of the of polio teams’ assets of the region
  • UNICEF: Economic, social and psychological costs and risks resulting from not investing in education systems in Syria
  • UNFPA: Cost of eliminating child marriage and intimate partner violence; an investment case study on HPV vaccination in Vietnam
  • FIA Foundation: Investing in reducing road traffic injuries among adolescents
  • Fred Hollows Foundation: Investing in women’s sight (Kenya, Laos and Pakistan)
     

Staff & students

Find out who's in our research group, and read our researcher bios via the links.

Staff

Contact us

Bruce Rasmussen
Email: bruce.rasmussen@vu.edu.au
Phone: +61 3 99191342