Social impact bonds for cancer prevention, repaid from avoided treatment costs
Investors would fund vaccination and screening campaigns up front and be repaid by health systems only if the campaigns hit verified targets, turning future savings into money for prevention now.
Outcome-based contracts in which private or philanthropic investors finance delivery programmes (HPV catch-up vaccination for adults up to 26 or 45, lung screening enrolment among smokers, hepatitis B and C test-and-treat, bowel screening uptake in low-participation areas) and the payer repays with a return only when independently verified coverage or diagnosis-stage targets are met. This shifts the risk of implementation failure from the health system to investors and aligns incentives on measured outcomes. Precedents exist in social care and in tuberculosis and HIV programmes in several countries.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.