Health technology assessment and public health: An alliance for better health systems

Introduction

One of the emerging problem in Public Health at the Globallevel is the limitedness of resources behind the spreading of new technologies and the growing of health needs, and this is particularly true in the developed world due to population aging and diffusion of incorrect life-styles. But these problems are of increasing interest also in the developing countries. 
Usually, Public Health interventions are developed to control, prevent and reduce health problems, such as obesity, sexual transmitted diseases, road and domestic injuries, but to decrease also the burden of chronic-degenerative and infectious diseases.
Methods

The Health Technology Assessment (HTA) approach is being used as a tool to study the effectiveness and the utility of primary, secondary and tertiary Public Health interventions to guarantee a high quality, efficient and efficacious Health National Service, as indicated by Walter Holland.

The project
At the HTA Public Health Unit of the Catholic University of the Sacred Heart in Rome,  a HTA program on Public Health issues has been developed, according to the problems pointed out by the Italian Prevention National Plan 2005-2007 which focuses on vaccinations, disease screenings, health promotion and educational campaign.
This project has the objective to apply the HTA approach to anti Human papillomavirus and anti-pneumococcus vaccines, caeliac disease population screening and interventions to reduce childhood obesity.
Each sub-project is composed by different phases:

1. Evaluation of disease burden;
   
2. Epidemiological evaluation of problem by a systematic review and a meta-analysis;
   
3. Economic evaluation applying two different approaches: cost-benefit and cost-effectiveness analysis;
   
4. Study of the social and legal implications of technology use;
   
5. Estimate of the organization involvements and evaluation of the best modality of allocation or introduction of  technology.
   

Conclusion
The HTA approach to Public Health problems could help all the stakeholder (politicians, public health professionals, patients) to understand the wide relationships between different approaches to the matter and to better allocate the resources in a world where economic resources are scarce.