Understanding the Economics of Microbial Threats Proceedings of a Workshop (2018) / Chapter Skim
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3 The Economic Cost of Endemic Infectious Diseases
3 The Economic Cost of Endemic Infectious Diseases
Pages 13-28
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From page 13... ...
Kimberly Thompson, president of Kid Risk, Inc., opened the session with an overview of the economic case for eradicating polio, evaluating the costs and benefits of both eradication and control strategies. K atharina Hauck, senior lecturer in health economics from the Imperial College London, followed with a discussion on the economic impact of HIV/AIDS on labor productivity and quality of life.
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From page 14... ...
. In populations with low OPV uptake, there may be enough susceptible, unvaccinated individuals nearby to sustain a paralytic polio outbreak if this were to occur.
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From page 15... ...
Because of treatment cost savings, the investment resulted in net economic benefits exceeding $180 billion, which does not include the intangible costs of suffering, death, and averted fear. A subsequent study revealed that transitioning from OPV-based control strategies to IPV-based eradication strategies, even in low-income settings, resulted in lower cumulative costs and cases of paralytic disease over a 20-year period (Thompson and Tebbens, 2007)
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From page 16... ...
For example, health expenditure and lost income from the disease's morbidity and mortality negatively affect household income, reducing consumption as well as savings and investments in income-generating activities. This in turn lowers investment in capital and lowers labor productivity and GDP.
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From page 17... ...
Focus on Labor Productivity and Health-Related Quality of Life With better individual and household data, economists have begun to focus on the key factor identified in the general equilibrium model: labor productivity. Hauck presented a cross-sectional study of more than 17,000 individuals from nine communities with high prevalence of HIV in
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From page 18... ...
. The study compared productive days lost attributable to health-seeking behavior and illness over the past 3 months, between HIV positive and HIV negative individuals.
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From page 19... ...
This strategy involves initiating ART for HIV positive individuals as soon as they are diagnosed. She added that early ART is beneficial not only for the patients, who reap health benefits, but also for their sexual partners, who will have a lower risk of contracting the disease.
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From page 20... ...
. She presented additional research that models the positive impact of effective treatment of drug-sensitive and multidrug-resistant TB and expanded access to TB care on catastrophic financial costs faced by families in South Africa and India (Verguet et al., 2017)
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From page 21... ...
While this strategy would strain the public-sector budget, it would also be associated with substantial reductions in health and economic costs borne by patients, she said. New Technology Development and Uptake for Tuberculosis Control Vassall discussed the challenge of new technology development and uptake for TB care, noting that even when these technologies become available, they might not prove to be cost-effective.
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From page 22... ...
These proximal constraints are in turn influenced by distal constraints such as underlying values and preferences, cultural norms, and household resources. On the supply side, the knowledge and behavior of health care providers as well as the availability of staff and supplies may be potential proximal constraints; distal factors such as human resource availability, health financing, and the functioning of health systems may influence those proximal constraints.
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From page 23... ...
FIGURE 3-4 Conceptual framework for identifying demand and supply constraints in the context of introducing interventions in the care pathway. 23 SOURCES: Vassall presentation, June 12, 2018; Vassall et al., 2016.
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Vassall responded that economic incentives are in fact being used, and cited a recent study that suggested that conditional cash transfers and social support had a positive effect on TB treatment (Wingfield et al., 2017)
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From page 25... ...
Vassall emphasized the need for a greater understanding of the impact of borrowing not only on families facing financial catastrophes because of TB infection, but also in the communities to which they belong. The current studies only look at the economic effect at the individual/household level, but it is clear that the economic decisions at this level ripple into the community as it affects the lenders' household savings and investment horizons, she said.
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From page 26... ...
In contrast, Vassall said that TB is not at the last mile stage yet, particularly because of challenges with latent TB, but there is nevertheless a need to expand focus beyond health services. Currently, she said health systems rely on infected individuals to present themselves to facilities, but in the future health workers will need to actively search for cases, which will have higher cost implications.
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From page 27... ...
These resources proved critical during the 2002–2004 severe acute respiratory syndrome outbreak and more recently for the Ebola response in Nigeria. Hauck responded to Goodman's question of changing costs and benefits related to control efforts by stating that for HIV these changes are mainly relevant to the cost of the drug treatment.
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From page 28... ...
She stated that there is a need to focus on how policy makers operate and the mechanism necessary for them to implement relevant policies.
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