Publication: Economic Benefit of Tuberculosis Control
Date
2007-08
ISSN
Published
2007-08
Author(s)
Laxminarayan, Ramanan
Klein, Eili
Dye, Christopher
Floyd, Katherine
Darley, Sarah
Adeyi, Olusoji
Abstract
Tuberculosis is the most important
infectious cause of adult deaths after HIV/AIDS in low- and
middle-income countries. This paper evaluates the economic
benefits of extending the World Health Organization's
DOTS Strategy (a multi-component approach that includes
directly observed treatment, short course chemotherapy and
several other components) as proposed in the Global Plan to
Stop TB, 2006-2015. The authors use a model-based approach
that combines epidemiological projections of averted
mortality and economic benefits measured using value of
statistical life for the Sub-Saharan Africa region and the
22 high-burden, tuberculosis-endemic countries in the world.
The analysis finds that the economic benefits between 2006
and 2015 of sustaining DOTS at current levels relative to
having no DOTS coverage are significantly greater than the
costs in the 22 high-burden, tuberculosis-endemic countries
and the Africa region. The marginal benefits of implementing
the Global Plan to Stop TB relative to a no-DOTS scenario
exceed the marginal costs by a factor of 15 in the 22
high-burden endemic countries, a factor of 9 (95% CI, 8-9)
in the Africa region, and a factor of 9 (95% CI, 9-10) in
the nine high-burden African countries. Uncertainty analysis
shows that benefit-cost ratios of the Global Plan strategy
relative to sustained DOTS were unambiguously greater than
one in all nine high-burden countries in Africa and in
Afghanistan, Pakistan, and Russia. Although HIV curtails the
effect of the tuberculosis programs by lowering the life
expectancy of those receiving treatment, the benefits of the
Global Plan are greatest in African countries with high
levels of HIV.
Citation
“Laxminarayan, Ramanan; Klein, Eili; Dye, Christopher; Floyd, Katherine; Darley, Sarah; Adeyi, Olusoji. 2007. Economic Benefit of Tuberculosis Control. Policy Research Working Paper; No. 4295. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/64cb74d3-179a-58cf-bc3e-8c834e77660e License: CC BY 3.0 IGO.”
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