If the Fred Hollows Foundation can restore sight for $25 in undeveloped counties, why is medical treatment so expensive in developed countries?

Digging a little deeper into the Fred Hollows website, I noted that one of the causes of preventable blindness is trachoma, which is caused by a Chlamydia bacterium. This is typically treated with antibiotics: tetracycline or azithromycin.

While tetracycline is relatively cheap, it needs to be applied twice a day for 6 weeks, and is unsuitable for pregnant women, and children under 8 years of age. WHO recommends mass antibiotic treatment of childhood trachoma when the infection rate reaches 10% of children in a region. Such treatment could be provided by anyone, once the infection rate determination is made – there’s no need for doctors, hospitals, etc., just someone competent to give out the recommended dose.

Azithromycin is expensive but can be given as a single dose, and is safe for pregnant women and children over 6 months of age. Prices on the internet vary from £3.20 (UK NHS price) per child, to US$25 for 6x250mg tablets.

So there it is: the Foundation is using the US cost of efficiently treating trachoma as its baseline cost of treating preventable blindness.