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Marita Mann began her career in chemical engineering, but always had a strong interest in global health after studying abroad and volunteering in health clinics in South Africa. These experiences, along with a desire to influence health on a higher level, led her to switch gears and to pursue a career in global and public health. As an MPH student in global health at Brown University, Mann found it surprising that many people in the field did not place a strong emphasis on the cost effectiveness of health interventions. She explained, "Often people think about costs, so far as their grant can pay for three to five years in intervention, but not about the cost effectiveness and how much health we’re getting for our money." Her search for PhD programs that incorporated economics into public health led her to the health economics and outcomes research program at the University of Washington. It was her advisers at UW who connected her with TREE in 2013, which had been in the process of publishing the results from a cervical cancer screening clinical trial in Kenya, but received feedback from reviewers that they wanted more information about the cost-effectiveness of the screening methods. This was the perfect project for Mann's talents and interests. Kenya has a high prevalence of HIV and the HIV-positive population is particularly susceptible to cervical cancer. In recent years, there has been increased availability of cervical screening along with a rapidly rising number of options for screening and treatment.
Mann's work asks, "Do we use the cheapest [option] or is it worth the extra money for more effective screens?" Costs are analyzed from both a societal and payer perspective. The former takes into account all costs to society involving the health program, the patients, caregivers, physicians, nurses, and so forth. The payer perspective, on the other hand, looks at costs to the health center, such as the cervical cancer screen, facility costs, physician time to the patient, transportation, and more. Effectiveness of the screens is determined by looking at health outcomes, for example mortality or biomarkers, and hopefully later through quality of life measures. The nature and cultural context of this study poses many challenges to Mann's work. Quality of life measures are highly subjective to disease area and also differ by culture, meaning similar cervical cancer studies between the US and Kenya may not be compatible for comparison. Also, due to the complexity of cervical cancer, accuracy in disease models is extraordinarily difficult. Regardless, Mann points out that the exact values aren't the goal, explaining, "In economics, we sometimes say all models are wrong but some are useful.
The most important thing to come out of a cost effectiveness model is what are the important factors to think about." She stresses that they are still able to identify important factors, such as what age to screen patients at, and the comparative cost effectiveness of the screens. When not exploring the intersection between economics and health care, Mann spends her free time outdoors, enjoying activities including hiking and camping, often with her dog. She has climbed Mt. Kilimanjaro, claiming the experience to be "amazing but terrible," and has set her sights toward ascending Mt. Kenya.