The Socioeconomic Benefit to Individuals of Achieving the 2020 Targets for Five Preventive Chemotherapy Neglected Tropical Diseases

Abstract

BackgroundLymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminths (STH) and trachoma represent the five most prevalent neglected tropical diseases (NTDs). They can be controlled or eliminated by means of safe and cost-effective interventions delivered through programs of Mass Drug Administration (MDA)—also named Preventive Chemotherapy (PCT). The WHO defined targets for NTD control/elimination by 2020, reinforced by the 2012 London Declaration, which, if achieved, would result in dramatic health gains. We estimated the potential economic benefit of achieving these targets, focusing specifically on productivity and out-of-pocket payments.MethodsProductivity loss was calculated by combining disease frequency with productivity loss from the disease, from the perspective of affected individuals. Productivity gain was calculated by deducting the total loss expected in the target achievement scenario from the loss in a counterfactual scenario where it was assumed the pre-intervention situation in 1990 regarding NTDs would continue unabated until 2030. Economic benefits from out-of-pocket payments (OPPs) were calculated similarly. Benefits are reported in 2005 US$ (purchasing power parity-adjusted and discounted at 3% per annum from 2010). Sensitivity analyses were used to assess the influence of changes in input parameters.ResultsThe economic benefit from productivity gain was estimated to be I$251 billion in 2011–2020 and I$313 billion in 2021–2030, considerably greater than the total OPPs averted of I$0.72 billion and I$0.96 billion in the same periods. The net benefit is expected to be US$ 27.4 and US$ 42.8 for every dollar invested during the same periods. Impact varies between NTDs and regions, since it is determined by disease prevalence and extent of disease-related productivity loss.ConclusionAchieving the PCT-NTD targets for 2020 will yield significant economic benefits to affected individuals. Despite large uncertainty, these benefits far exceed the investment required by governments and their development partners within all reasonable scenarios. Given the concentration of the NTDs among the poorest households, these investments represent good value for money in efforts to share the world’s prosperity and reduce inequity.

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

“…More recently, Redekop et al . and Kim et al . quantified the economic benefits associated with onchocerciasis elimination.…”

“… and Redekop et al . included the productivity gains associated with preventing onchocerciasis‐associated skin disease when quantifying the economic benefits of onchocerciasis interventions. Kim et al .…”

“…In Redekop et al . 's study, the benefits associated with preventing skin disease represented 22% of the total projected economic benefit. This assumed that ‘moderate’ skin disease is associated with a 10% productivity loss and ‘mild’ skin disease is associated with no productivity loss (Table ).…”

“…In contrast, both Kim et al [60] and Redekop et al [59] included the productivity gains associated with preventing onchocerciasis-associated skin disease when 356 potentially relevant records identified through the databases 3 additional records were found from other sources 329 records after duplicates removed 14 relevant records indentified 37 records were excluded based on their abstracts 51 records retrived for more detailed review based on the abstracts 288 records were initially excluded after scannig their titles Figure 1 Decision tree outlining the inclusion and exclusion of the identified studies. Some studies reported both cost-benefit and costeffectiveness estimates.…”

“…More recently, Redekop et al [59] and Kim et al [60] quantified the economic benefits associated with onchocerciasis elimination. Both those studies found that eliminating onchocerciasis would generate billions in economic benefits (Tables 1 and 3).…”