Economic analysis of the global polio eradication initiative

Tebbens, Radboud J. Duintjer; Pallansch, Mark A.; Cochi, Stephen L.; Wassilak, Steven G.F.; Linkins, Jennifer; Sutter, Roland W.; Aylward, R. Bruce; Thompson, Kimberly M.

doi:10.1016/j.vaccine.2010.10.026

Cited by 126 publications

(109 citation statements)

References 28 publications

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“…A recent economic analysis of the Global Polio Eradication Initiative by Duintjer Tebbens et al [10] found that eradication achieved using OPV results in a higher overall pay-off than routine vaccination with OPV without eradication being attempted-the difference is about $42 billion in present value terms. As shown in figure 2, starting from p** , p c , increasing vaccination only makes sense if by doing so the disease can be eradicated, allowing countries to stop vaccinating in the future.…”

Section: (B) Poliomyelitismentioning

confidence: 99%

“…As shown in figure 2, starting from p** , p c , increasing vaccination only makes sense if by doing so the disease can be eradicated, allowing countries to stop vaccinating in the future. Duintjer Tebbens et al [10], however, not only assume that vaccination continues, they also assume that in the posteradication world, countries switch to the more costly IPV. This makes their results surprising.…”

Section: (B) Poliomyelitismentioning

confidence: 99%

“…Another crucial assumption concerns the post-eradication scenario, especially whether vaccination is continued. Duintjer Tebbens et al [10] calculate that vaccination cessation in the post-eradication era would raise the net benefits of eradication (compared with the alternative) to $47 billion (from $42 billion with continued vaccination, both numbers expressed in present value terms). It is surprising that vaccination cessation should appear this unimportant, but this analysis begins in 1988, assumes that vaccination ceases in 2016, and terminates in 2035.…”

Section: (B) Poliomyelitismentioning

confidence: 99%

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Economic considerations for the eradication endgame

Barrett

2013

Phil. Trans. R. Soc. B

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An infectious disease will be eradicated only if it is eliminated everywhere, including in the hardest-to-reach, most vaccine-wary communities. If eradication is successful, it promises a dividend in the form of avoided infections and vaccinations. However, success is never certain unless and until eradication is achieved, and claiming the dividend means bearing the possibly great risk of re-emergence. Economic analysis of eradication evaluates these risks and rewards relative to the alternative of ‘optimal control’, and also exposes the incentives for achieving and capitalizing on eradication. Eradication is a ‘game’, because some countries may be willing to eliminate the disease within their borders only if assured that all others will eliminate the disease within their borders. International financing is also a game, because each country would rather free ride than contribute. Finally, for diseases such as polio, capitalizing on eradication is a game, for should any country continue to vaccinate in the post-eradication era using the live-attenuated polio vaccine, the countries that stop vaccinating will be exposed to the risk of vaccine-derived polioviruses. In the framework developed in this paper, eradication is a seductive goal, its attainment fraught with peril.

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Section: (B) Poliomyelitismentioning

confidence: 99%

Section: (B) Poliomyelitismentioning

confidence: 99%

Section: (B) Poliomyelitismentioning

confidence: 99%

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Economic considerations for the eradication endgame

Barrett

2013

Phil. Trans. R. Soc. B

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“…However, the current WHO SAGE recommendation suggests that after global OPV withdrawal, all countries should include ‘at least 2 doses of IPV in their routine immunization schedule’ for at least 10 years after OPV withdrawal [64]. This recommendation implies significant costs for the polio endgame, and it will make the overall cost of polio eradication significantly higher than assumed by prior analyses [40,67]. Given that SAGE made its recommendation without any consideration of cost or cost-effectiveness, we anticipate that in the next 5 years, national governments will evaluate their commitment to continued IPV vaccination, and this may lead to reconsideration of the SAGE IPV recommendation.…”

Section: Five-year Viewmentioning

confidence: 99%

Polio endgame risks and the possibility of restarting the use of oral poliovirus vaccine

Tebbens¹,

Thompson²

2018

Expert Review of Vaccines

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Introduction: Ending all cases of poliomyelitis requires successful cessation of all oral poliovirus vaccine (OPV), but the Global Polio Eradication Initiative (GPEI) partners should consider the possibility of an OPV restart.Areas covered: We review the risks of continued live poliovirus transmission after OPV cessation and characterize events that led to OPV restart in a global model that focused on identifying optimal strategies for OPV cessation and the polio endgame. Numerous different types of events that occurred since the globally coordinated cessation of serotype 2-containing OPV in 2016 highlight the possibility of continued outbreaks after homotypic OPV cessation. Modeling suggests a high risk of uncontrolled outbreaks once more than around 5,000 homotypic polio cases occur after cessation of an OPV serotype, at which point restarting OPV would become necessary to protect most populations. Current efforts to sunset the GPEI and transition its responsibilities to national governments poses risks that may limit the ability to implement management strategies needed to minimize the probability of an OPV restart.Expert commentary: OPV restart remains a real possibility, but risk management choices made by the GPEI partners and national governments can reduce the risks of this low-probability but high-consequence event.

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“…A recent study of Duintjer Tebbens et al [14] has attempted to quantify the economic benefits of global polio eradication. It comes to the conclusion that the incremental net benefits (1988 net present value in 2008 dollars) is US$40-50 billion.…”

Section: The Global Poliomyelitis Eradication Initiativementioning

confidence: 99%

Vaccines and future global health needs

Nossal

2011

Phil. Trans. R. Soc. B

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Increased international support for both research into new vaccines and their deployment in developing countries has been evident over the past decade. In particular, the GAVI Alliance has had a major impact in increasing uptake of the six common infant vaccines as well as those against hepatitis B and yellow fever. It further aims to introduce pneumococcal and rotavirus vaccines in the near future and several others, including those against human papillomavirus, meningococcal disease, rubella and typhoid not long after that. In addition, there is advanced research into vaccines against malaria, HIV/AIDS and tuberculosis. By 2030, we may have about 20 vaccines that need to be used in the developing world. Finding the requisite funds to achieve this will pose a major problem. A second and urgent question is how to complete the job of global polio eradication. The new strategic plan calls for completion by 2013, but both pre-eradication and post-eradication challenges remain. Vaccines will eventually become available beyond the field of infectious diseases. Much interesting work is being done in both autoimmunity and cancer. Cutting across disease groupings, there are issues in methods of delivery and new adjuvant formulations.

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Economic analysis of the global polio eradication initiative

Cited by 126 publications

References 28 publications

Economic considerations for the eradication endgame

Economic considerations for the eradication endgame

Polio endgame risks and the possibility of restarting the use of oral poliovirus vaccine

Vaccines and future global health needs

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