Preventing the White Death: Tuberculosis Dispensaries

Tuberculosis (TB) is a leading cause of death worldwide according to the WHO. This paper estimates the effect of TB dispensaries, designed to prevent the spread of the disease before the advent of modern medicine. Our difference-in-differences estimation reveals that the rollout of the TB dispensaries across Danish cities led to a 16 percent decline in the TB mortality rate, but no significant impacts on other diseases when performing placebo regressions. We next take advantage of the explicit targeting on TB by the dispensaries to setup a triple-differences model which exploits other diseases as controls and obtain a very similar magnitude of the effect. This evidence, along with the actual cost of the dispensaries, suggests the cost per saved life-year to be around 76 dollars. Our overall conclusion indicates that public policy played an important and effective role for the decline in TB mortality. It also stresses that dispensaries are of policy relevance for developing countries today as a cheap measure to counter the externalities created by TB and modern drug resistant strains.