Malaria elimination transmission and costing in the Asia-Pacific: Developing an investment case

Wellcome Open Research

article

Rima Shretta¹  Sheetal Prakash Silal⁴  Olivier J. Celhay⁷  Chris Erwin Gran Mercado⁷  Shwe Sin Kyaw⁷  Anton Avancena¹  Katie Fox¹  Brittany Zelman¹  Ranju Baral¹  Lisa Jane White⁵  Richard James Maude⁵ 

[1] Global Health Group, University of California;Swiss Tropical and Public Health Institute;University of Basel;Modelling and Simulation Hub, Africa, Department of Statistical Sciences, University of Cape Town;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford;South African DST-NRF Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University;Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University;Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University;Harvard TH Chan School of Public Health, Harvard University

关键词: malaria;    elimination;    financing;    costs;    government;    donor;    resource mobilization;   

DOI  :  10.12688/wellcomeopenres.14769.2

学科分类：内科医学

来源: Wellcome

【 摘 要 】

Background: The Asia-Pacific region has made significant progress against malaria, reducing cases and deaths by over 50% between 2010 and 2015. These gains have been facilitated in part, by strong political and financial commitment of governments and donors. However, funding gaps and persistent health system challenges threaten further progress. Achieving the regional goal of malaria elimination by 2030 will require an intensification of efforts and a plan for sustainable financing. This article presents an investment case for malaria elimination to facilitate these efforts.Methods: A transmission model was developed to project rates of decline ofPlasmodium falciparum andPlasmodium vivax malaria and the output was used to determine the cost of the interventions that would be needed for elimination by 2030. In total, 80 scenarios were modelled under various assumptions of resistance and intervention coverage. The mortality and morbidity averted were estimated and health benefits were monetized by calculating the averted cost to the health system, individual households, and society. The full-income approach was used to estimate the economic impact of lost productivity due to premature death and illness, and a return on investment was computed.Results: The study estimated that malaria elimination in the region by 2030 could be achieved at a cost of USD 29.02 billion (range: USD 23.65-36.23 billion) between 2017 and 2030. Elimination would save over 400,000 lives and avert 123 million malaria cases, translating to almost USD 90 billion in economic benefits. Discontinuing vector control interventions and reducing treatment coverage rates to 50% will result in an additional 845 million cases, 3.5 million deaths, and excess costs of USD 7 billion. Malaria elimination provides a 6:1 return on investment.Conclusion: This investment case provides compelling evidence for the benefits of continued prioritization of funding for malaria and can be used to develop an advocacy strategy.

【 授权许可】

CC BY