IDEAS home Printed from https://ideas.repec.org/a/plo/pntd00/0005934.html
   My bibliography  Save this article

How much will it cost to eradicate lymphatic filariasis? An analysis of the financial and economic costs of intensified efforts against lymphatic filariasis

Author

Listed:
  • Randee J Kastner
  • Elisa Sicuri
  • Christopher M Stone
  • Gabriel Matwale
  • Ambrose Onapa
  • Fabrizio Tediosi

Abstract

Introduction: Lymphatic filariasis (LF), a neglected tropical disease (NTD) preventable through mass drug administration (MDA), is one of six diseases deemed possibly eradicable. Previously we developed one LF elimination scenario, which assumes MDA scale-up to continue in all countries that have previously undertaken MDA. In contrast, our three previously developed eradication scenarios assume all LF endemic countries will undertake MDA at an average (eradication I), fast (eradication II), or instantaneous (eradication III) rate of scale-up. In this analysis we use a micro-costing model to project the financial and economic costs of each of these scenarios in order to provide evidence to decision makers about the investment required to eliminate and eradicate LF. Methodology/Key findings: Costing was undertaken from a health system perspective, with all results expressed in 2012 US dollars (USD). A discount rate of 3% was applied to calculate the net present value of future costs. Prospective NTD budgets from LF endemic countries were reviewed to preliminarily determine activities and resources necessary to undertake a program to eliminate LF at a country level. In consultation with LF program experts, activities and resources were further reviewed and a refined list of activities and necessary resources, along with their associated quantities and costs, were determined and grouped into the following activities: advocacy and communication, capacity strengthening, coordination and strengthening partnerships, data management, ongoing surveillance, monitoring and supervision, drug delivery, and administration. The costs of mapping and undertaking transmission assessment surveys and the value of donated drugs and volunteer time were also accounted for. Using previously developed scenarios and deterministic estimates of MDA duration, the financial and economic costs of interrupting LF transmission under varying rates of MDA scale-up were then modelled using a micro-costing approach. The elimination scenario, which includes countries that previously undertook MDA, is estimated to cost 929 million USD (95% Credible Interval: 884m-972m). Proceeding to eradication is anticipated to require a higher financial investment, estimated at 1.24 billion USD (1.17bn-1.30bn) in the eradication III scenario (immediate scale-up), with eradication II (intensified scale-up) projected at 1.27 billion USD (1.21bn-1.33bn), and eradication I (slow scale-up) estimated at 1.29 billion USD (1.23bn-1.34bn). The economic costs of the eradication III scenario are estimated at approximately 7.57 billion USD (7.12bn-7.94bn), while the elimination scenario is projected to have an economic cost of 5.21 billion USD (4.91bn-5.45bn). Countries in the AFRO region will require the greatest investment to reach elimination or eradication, but also stand to gain the most in cost savings. Across all scenarios, capacity strengthening and advocacy and communication represent the greatest financial costs, whereas mapping, post-MDA surveillance, and administration comprise the least. Conclusions/Significance: Though challenging to implement, our results indicate that financial and economic savings are greatest under the eradication III scenario. Thus, if eradication for LF is the objective, accelerated scale-up is projected to be the best investment. Author summary: Lymphatic filariasis (LF) is a neglected tropical disease (NTD) that is targeted for elimination and is thought to be potentially eradicable through once yearly mass drug administration (MDA) using drugs that are currently donated to LF endemic countries by the pharmaceutical companies that manufacture them. MDA has proven to be a cost-effective and efficient method of disease control, both for LF and other NTDs. Previously, we developed scale-up scenarios of varying magnitude to reach elimination (elimination of LF in all countries that have previously undertaken MDA) and eradication (local elimination of LF in all LF endemic countries) and estimated the number of associated treatments that would be necessary in each country under each scenario. Here we project the costs—both financial and economic—of each of these scenarios. We use data from a myriad of sources to estimate the cost of various activities, and found that training and advocacy and communication activities comprise the bulk of the costs of the program. Among all scenarios, elimination requires the least total investment. However, in terms of LF eradication, faster rates of MDA scale-up are associated with decreased overall costs.

Suggested Citation

  • Randee J Kastner & Elisa Sicuri & Christopher M Stone & Gabriel Matwale & Ambrose Onapa & Fabrizio Tediosi, 2017. "How much will it cost to eradicate lymphatic filariasis? An analysis of the financial and economic costs of intensified efforts against lymphatic filariasis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 11(9), pages 1-20, September.
  • Handle: RePEc:plo:pntd00:0005934
    DOI: 10.1371/journal.pntd.0005934
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005934
    Download Restriction: no

    File URL: https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005934&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pntd.0005934?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Laia Cirera & Beatriz Galatas & Sergi Alonso & Krijn Paaijmans & Miler Mamuquele & Helena Martí-Soler & Caterina Guinovart & Humberto Munguambe & Fabião Luis & Hoticha Nhantumbo & Júlia Montañà & Quiq, 2020. "Moving towards malaria elimination in southern Mozambique: Cost and cost-effectiveness of mass drug administration combined with intensified malaria control," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-17, July.
    2. Mousab Siddig Elhag & Yan Jin & Mutamad Ahmad Amin & Hassan Ahmed Hassan Ahmed Ismail & Sung-Tae Hong & Hae In Jang & Youngah Doh & Seungman Cha, 2020. "Cost and logistics implications of a nationwide survey of schistosomiasis and other intestinal helminthiases in Sudan: Key activities and cost components," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-18, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. David K. Evans & Arkadipta Ghosh, 2008. "Prioritizing Educational Investments in Children in the Developing World," Working Papers WR-587, RAND Corporation.
    2. Battaglia, Marianna & Lebedinski, Lara, 2015. "Equal Access to Education: An Evaluation of the Roma Teaching Assistant Program in Serbia," World Development, Elsevier, vol. 76(C), pages 62-81.
    3. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    4. Kirill Borusyak & Peter Hull & Xavier Jaravel, 2023. "Design-Based Identification with Formula Instruments: A Review," NBER Working Papers 31393, National Bureau of Economic Research, Inc.
    5. Mark D. Manuszak & Krzysztof Wozniak, 2017. "The Impact of Price Controls in Two-sided Markets : Evidence from US Debit Card Interchange Fee Regulation," Finance and Economics Discussion Series 2017-074, Board of Governors of the Federal Reserve System (U.S.).
    6. Hoffmann, Bridget, 2018. "Do non-monetary prices target the poor? Evidence from a field experiment in India," Journal of Development Economics, Elsevier, vol. 133(C), pages 15-32.
    7. Lay, Jann, 2010. "MDG Achievements, Determinants, and Resource Needs: What Has Been Learnt?," GIGA Working Papers 137, GIGA German Institute of Global and Area Studies.
    8. John A. List, 2024. "Optimally generate policy-based evidence before scaling," Nature, Nature, vol. 626(7999), pages 491-499, February.
    9. McNamara, Paul E. & Ulimwengu, John M. & Leonard, Kenneth L., 2010. "Do health investments improve agricultural productivity? Lessons from agricultural household and health research," IFPRI discussion papers 1012, International Food Policy Research Institute (IFPRI).
    10. Annette N. Brown & Drew B. Cameron & Benjamin D. K. Wood, 2014. "Quality evidence for policymaking: I'll believe it when I see the replication," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 6(3), pages 215-235, September.
    11. Tanguy Bernard & Sylvie Lambert & Karen Macours & Margaux Vinez, 2019. "Adoption of Improved Seeds, Evidence from DRC," Working Papers halshs-02422695, HAL.
    12. Janet Currie & Tom Vogl, 2013. "Early-Life Health and Adult Circumstance in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 5(1), pages 1-36, May.
    13. Brown, Drusilla K. & Downes, Thomas & Eggleston, Karen & Kumari, Ratna, 2009. "Human Resource Management Technology Diffusion through Global Supply Chains: Buyer-directed Factory-based Health Care in India," World Development, Elsevier, vol. 37(9), pages 1484-1493, September.
    14. Philipp Ager & Casper Worm Hansen & Peter Z. Lin, 2023. "Medical Technology and Life Expectancy: Evidence from the Antitoxin Treatment of Diphtheria," Working Papers 0241, European Historical Economics Society (EHES).
    15. Ellis, Jimmy R. & Gershenson, Seth, 2016. "LATE for the Meeting: Gender, Peer Advising, and College Success," IZA Discussion Papers 9956, Institute of Labor Economics (IZA).
    16. Aggarwal, Khushboo & Barua, Rashmi & Vidal-Fernandez, Marian, 2024. "Still Waters Run Deep: Groundwater Contamination and Education Outcomes in India," Economics of Education Review, Elsevier, vol. 100(C).
    17. Martin, Will, 2021. "Tools for measuring the full impacts of agricultural interventions," IFPRI-MCC technical papers 2, International Food Policy Research Institute (IFPRI).
    18. Bharti Nandwani & cjain@3ieimpact.org, 2022. "Female representation in school management and school quality," Indira Gandhi Institute of Development Research, Mumbai Working Papers 2022-002, Indira Gandhi Institute of Development Research, Mumbai, India.
    19. Riphahn, Regina T., 2004. "The Enrollment Effect of Secondary School Fees in Post-War Germany," IZA Discussion Papers 1295, Institute of Labor Economics (IZA).
    20. Mariapia Mendola & Mengesha Yayo Negasi, 2019. "Nutritional and Schooling Impact of a Cash Transfer Program in Ethiopia: A Retrospective Analysis of Childhood Experience," Development Working Papers 451, Centro Studi Luca d'Agliano, University of Milano.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pntd00:0005934. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosntds (email available below). General contact details of provider: https://journals.plos.org/plosntds/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.