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A Cost--Benefit Analysis of Cholera Vaccination Programs in Beira, Mozambique

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  • Marc Jeuland
  • Marcelino Lucas
  • John Clemens
  • Dale Whittington

Abstract

Economic and epidemiological data collected in Beira, Mozambique, are used to conduct this first social cost--benefit analysis for cholera vaccination in Sub-Saharan Africa. The analysis compares the net economic benefits of three immunization strategies with and without user fees: school-based vaccination for school children only (age 5--14), school-based vaccination for all children (age 1--14), and a mass vaccination campaign for all people older than one year. All options assume the use of a low-cost new-generation oral cholera vaccine. The analysis incorporates the latest knowledge of vaccine effectiveness, including new evidence on the positive externality associated with the resulting herd protection (both protection of unvaccinated individuals and enhanced protection among vaccinated individuals arising from vaccination of a portion of the population). It also uses field data for incidence, benefits (private willingness to pay, public cost of illness), and costs (production, shipping, delivery, private travel costs). Taking herd protection into account has important economic implications. For a wide variety of parameters values, vaccination programs in Beira pass a cost--benefit test. Small school-based programs with and without user fees are very likely to provide net benefits. A mass vaccination campaign without user fees would result in the greatest reduction in the disease burden, but the social costs would likely outweigh the benefits, and such a program would require substantial public sector investment. As user fees increase, mass vaccination becomes much more attractive, and the reduction in disease burden remains above 70 percent at relatively low user fees. Copyright The Author 2009. Published by Oxford University Press on behalf of the International Bank for Reconstruction and Development / the world bank . All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org, Oxford University Press.

Suggested Citation

  • Marc Jeuland & Marcelino Lucas & John Clemens & Dale Whittington, 2009. "A Cost--Benefit Analysis of Cholera Vaccination Programs in Beira, Mozambique," The World Bank Economic Review, World Bank, vol. 23(2), pages 235-267, July.
    • Handle: RePEc:oup:wbecrv:v:23:y:2009:i:2:p:235-267
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    File URL: http://hdl.handle.net/10.1093/wber/lhp006
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    Citations

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    Cited by:

    1. Christian Schaetti & Mitchell G Weiss & Said M Ali & Claire-Lise Chaignat & Ahmed M Khatib & Rita Reyburn & Radboud J Duintjer Tebbens & Raymond Hutubessy, 2012. "Costs of Illness Due to Cholera, Costs of Immunization and Cost-Effectiveness of an Oral Cholera Mass Vaccination Campaign in Zanzibar," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 6(10), pages 1-10, October.
    2. Joseph Cook & Marc Jeuland & Brian Maskery & Dale Whittington, 2012. "Giving Stated Preference Respondents “Time to Think”: Results From Four Countries," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 51(4), pages 473-496, April.
    3. Richard T. Carson, 2012. "Contingent Valuation: A Practical Alternative When Prices Aren't Available," Journal of Economic Perspectives, American Economic Association, vol. 26(4), pages 27-42, Fall.
    4. Marc A Jeuland & Subhrendu K Pattanayak, 2012. "Benefits and Costs of Improved Cookstoves: Assessing the Implications of Variability in Health, Forest and Climate Impacts," PLOS ONE, Public Library of Science, vol. 7(2), pages 1-15, February.
    5. Whittington, Dale & Jeuland, Marc & Barker, Kate & Yuen, Yvonne, 2012. "Setting Priorities, Targeting Subsidies among Water, Sanitation, and Preventive Health Interventions in Developing Countries," World Development, Elsevier, vol. 40(8), pages 1546-1568.
    6. Aziz, Sonia & Pakhtigian, Emily L. & Akanda, Ali S. & Jutla, Antarpreet & Huq, Anwar & Alam, Munirul & Ashan, Gias U. & Colwell, Rita R., 2021. "Does improved risk information increase the value of cholera prevention? An analysis of stated vaccine demand in slum areas of urban Bangladesh," Social Science & Medicine, Elsevier, vol. 272(C).
    7. Jeuland, Marc & Lucas, Marcelino & Clemens, John & Whittington, Dale, 2010. "Estimating the private benefits of vaccination against cholera in Beira, Mozambique: A travel cost approach," Journal of Development Economics, Elsevier, vol. 91(2), pages 310-322, March.

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