An Investment Case for Ending Neglected Tropical Diseases

Fitzpatrick, Christopher; Nwankwo, Uzoma; Lenk, Edeltraud J.; Vlas, Sake J. de; Bundy, Donald

doi:10.1596/978-1-4648-0524-0_ch17

Cited by 37 publications

(40 citation statements)

References 53 publications

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“…This is consistent with the findings of a systematic review by Keating et al . , in which the average of identified onchocerciasis‐specific cost estimates was US$0.46 per treatment, as well as with recent MDA cost benchmarks estimated by the WHO . However, it is important to note that the costs of MDA delivery vary across different settings.…”

Section: Resultsmentioning

confidence: 99%

“…The cost‐effectiveness threshold set by the WHO‐CHOICE (a cost per DALY averted < 3 times the country's GDP per capita) is now considered to be too high . Most analyses within the NTD field have not used it , many opting instead for the more conservative cost‐effectiveness threshold set by the World Bank (≤ US$251 per DALY averted, when adjusted for inflation to 2016 prices ). Interestingly, recent analyses have indicated that a cost‐effectiveness threshold closer to < ½ the country's per capita GDP would be more appropriate for low‐income countries .…”

Section: Resultsmentioning

confidence: 99%

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Economic evaluations of onchocerciasis interventions: a systematic review and research needs

Turner

Walker

Pion

et al. 2019

Tropical Med Int Health

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Objective To provide a systematic review of economic evaluations that has been conducted for onchocerciasis interventions, to summarise current key knowledge and to identify research gaps. Method A systematic review of the literature was conducted on the 8th of August 2018 using the PubMed ( MEDLINE ) and ISI Web of Science electronic databases. No date or language stipulations were applied to the searches. Results We identified 14 primary studies reporting the results of economic evaluations of onchocerciasis interventions, seven of which were cost‐effectiveness analyses. The studies identified used a variety of different approaches to estimate the costs of the investigated interventions/programmes. Originally, the studies only quantified the benefits associated with preventing blindness. Gradually, methods improved and also captured onchocerciasis‐associated skin disease. Studies found that eliminating onchocerciasis would generate billions in economic benefits. The majority of the cost‐effectiveness analyses evaluated annual mass drug administration ( MDA ). The estimated cost per disability‐adjusted life year ( DALY ) averted of annual MDA varies between US $3 and US $30 (cost year variable). Conclusions The cost benefit and cost effectiveness of onchocerciasis interventions have consistently been found to be very favourable. This finding provides strong evidential support for the ongoing efforts to eliminate onchocerciasis from endemic areas. Although these results are very promising, there are several important research gaps that need to be addressed as we move towards the 2020 milestones and beyond.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Economic evaluations of onchocerciasis interventions: a systematic review and research needs

Turner

Walker

Pion

et al. 2019

Tropical Med Int Health

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“…A discount rate of 3% per annum was applied for both costs and benefits. More detailed information on the ROI and the internal rate of return per WHO region, as well as other considerations on the investment case of ending/controlling NTD, can be found in the recently published DCP3/World Bank volume on infectious diseases by Fitzpatrick et al [ 95 ]…”

Section: Methodsmentioning

confidence: 99%

“…The rough estimates of the return on investment calculated in this study were not subject to sensitivity analysis, following the original publication by Fitzpatrick et al [ 95 ].…”

Section: Methodsmentioning

confidence: 99%

Socioeconomic benefit to individuals of achieving 2020 targets for four neglected tropical diseases controlled/eliminated by innovative and intensified disease management: Human African trypanosomiasis, leprosy, visceral leishmaniasis, Chagas disease

et al. 2018

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BackgroundThe control or elimination of neglected tropical diseases (NTDs) has targets defined by the WHO for 2020, reinforced by the 2012 London Declaration. We estimated the economic impact to individuals of meeting these targets for human African trypanosomiasis, leprosy, visceral leishmaniasis and Chagas disease, NTDs controlled or eliminated by innovative and intensified disease management (IDM).MethodsA systematic literature review identified information on productivity loss and out-of-pocket payments (OPPs) related to these NTDs, which were combined with projections of the number of people suffering from each NTD, country and year for 2011–2020 and 2021–2030. The ideal scenario in which the WHO’s 2020 targets are met was compared with a counterfactual scenario that assumed the situation of 1990 stayed unaltered. Economic benefit equaled the difference between the two scenarios. Values are reported in 2005 US$, purchasing power parity-adjusted, discounted at 3% per annum from 2010. Probabilistic sensitivity analyses were used to quantify the degree of uncertainty around the base-case impact estimate.ResultsThe total global productivity gained for the four IDM-NTDs was I$ 23.1 (I$ 15.9 –I$ 34.0) billion in 2011–2020 and I$ 35.9 (I$ 25.0 –I$ 51.9) billion in 2021–2030 (2.5th and 97.5th percentiles in brackets), corresponding to US$ 10.7 billion (US$ 7.4 –US$ 15.7) and US$ 16.6 billion (US$ 11.6 –US$ 24.0). Reduction in OPPs was I$ 14 billion (US$ 6.7 billion) and I$ 18 billion (US$ 10.4 billion) for the same periods.ConclusionsWe faced important limitations to our work, such as finding no OPPs for leprosy. We had to combine limited data from various sources, heterogeneous background, and of variable quality. Nevertheless, based on conservative assumptions and subsequent uncertainty analyses, we estimate that the benefits of achieving the targets are considerable. Under plausible scenarios, the economic benefits far exceed the necessary investments by endemic country governments and their development partners. Given the higher frequency of NTDs among the poorest households, these investments represent good value for money in the effort to improve well-being, distribute the world’s prosperity more equitably and reduce inequity.

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“…Chagas disease (CD), caused by Trypanosoma cruzi, belongs to the group of neglected tropical diseases that affects more than 1 billion of the poorest and most marginalized people in the world [1]. It is estimated that 6-7 million people are infected with T. cruzi,~30,000 new cases of T. cruzi infection emerge each year, and CD accounts for >12,000 deaths per year (World Health Organization (WHO) Epidemiology, http://www.who.int/chagas/epidemiology/en/).…”

Section: Introductionmentioning

confidence: 99%

Potential Role of Antioxidants as Adjunctive Therapy in Chagas Disease

Sánchez-Villamil

Bautista-Niño

Serrano

et al. 2020

Oxidative Medicine and Cellular Longevity

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Chagas disease (CD) is one of the most important neglected tropical diseases in the American continent. Host-derived nitroxidative stress in response to Trypanosoma cruzi infection can induce tissue damage contributing to the progression of Chagas disease. Antioxidant supplementation has been suggested as adjuvant therapy to current treatment. In this article, we synthesize and discuss the current evidence regarding the use of antioxidants as adjunctive compounds to fight harmful reactive oxygen species and lower the tissue oxidative damage during progression of chronic Chagas disease. Several antioxidants evaluated in recent studies have shown potential benefits for the control of oxidative stress in the host’s tissues. Melatonin, resveratrol, the combination of vitamin C/vitamin E (vitC/vitE) or curcumin/benznidazole, and mitochondria-targeted antioxidants seem to be beneficial in reducing plasma and cardiac levels of lipid peroxidation products. Nevertheless, further research is needed to validate beneficial effects of antioxidant therapies in Chagas disease.

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An Investment Case for Ending Neglected Tropical Diseases

Cited by 37 publications

References 53 publications

Economic evaluations of onchocerciasis interventions: a systematic review and research needs

Economic evaluations of onchocerciasis interventions: a systematic review and research needs

Socioeconomic benefit to individuals of achieving 2020 targets for four neglected tropical diseases controlled/eliminated by innovative and intensified disease management: Human African trypanosomiasis, leprosy, visceral leishmaniasis, Chagas disease

Potential Role of Antioxidants as Adjunctive Therapy in Chagas Disease

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