Leaving aside for a moment the relationship to counterinsurgency and allowing me to oversimplify a bit: with public health-related projects greater avoided costs over the long term are associated with greater upfront costs. Rational planning of a public health-related project should begin by asking whether avoiding cost over time is the raison d'être. If the answer is “yes,” the next question should be whether meeting the upfront costs is feasible (not a purely financial matter, as there are political and social realities to take into consideration).

Returning to the issue of counterinsurgency, is there real evidence that providing healthcare is a successful means of winning hearts and minds?* I’m not trying to be a troll here but rather am seriously asking whether the concept can truly be said to rise above the level of assertion.

*Note that my question is not whether providing access to healthcare improves quality of life. I am taking that for granted.