Rothman et al. Respond

We could not agree more with Abudu that a human rights perspective is an important component of a public health response to human trafficking. However, we do not agree that we should abandon cost estimate research on human trafficking.

According to Wayne Giles of the US Centers for Disease Control and Prevention, “as we work to improve the health and wellbeing of populations, it is increasingly important that our interventions demonstrate their ability to improve the health and delivery of care to populations while simultaneously addressing costs.”^1(p164) Cost analyses are a critical component of public health decision-making in general and are carried out by notable entities such as the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the Public Health Practice-Based Research Network.

Abudu worries that cost estimate research would show that the cost of human trafficking to society is trivial in comparison with the billions it generates in illegal revenue. To clarify, in our opinion, the lucrative nature of human trafficking for criminals should not be part of an assessment of the direct and indirect costs of trafficking. Only expenses incurred by legitimate sectors such as criminal justice and health care are taxpayers’ concern. The Centers for Disease Control and Prevention’s report Costs of Intimate Partner Violence Against Women in the United States provides an excellent example of how the financial burdens of interpersonal violence can be calculated. We advocate for using that model as a guide for human trafficking.²

In conclusion, we appreciate the spirit and enthusiasm of Abudu’s letter, but we do not agree that human trafficking should be reframed exclusively as an ethical and moral issue. Public health experts must be informed by human rights principles, medical ethics, and scientific evidence, including cost analyses.