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Health minister highlights dengue’s economic impact

28 Jan 2009

Paul Chinnock

Source: The Star Online (Malaysia) (see original article)

Figure 1
Malaysia’s Parliament building: Mohd Hafiz Noor Shams

Announcing a major campaign against the current outbreak of dengue fever in Malaysia, health minister Datuk Liow Tiong Lai warned that, “The high number of cases can affect productivity, the tourism industry and, ultimately, our economy,”

In the first three weeks of 2009, there were 4,221 recorded cases of dengue in Malaysia, including 12 deaths. There were 2,223 cases and five deaths in the same period last year.

The ‘fogging’ of residential areas with insecticide to kill Aedes aegypti mosquitoes (the vector of the dengue virus) is a long-established part of life in Malaysia and the government has recently launched a major public education programme. However, control activities are to be considerably expanded, with an emphasis on public awareness. Mr Liow said the government would work with community and non-governmental organisations in dengue control activities, such as identifying and destroying mosquito-breeding areas on a weekly basis.

A heavy economic burden

The highlighting by the minister of the economic impact of dengue echoes global concerns on this question. Last year, for example, a workshop organised by APEC (Asian-Pacific Economic Cooperation) was held in Taipei to discuss the control of dengue, given the ‘heavy economic burden’ imposed by the disease. It is, however, hard to quantify the costs involved and relatively little research has been done on this question.

Most people with dengue fever do recover but when, at the height of an epidemic, so many of the workforce are sick and unable to work, the cost to the national economy will be high. Many areas with a dengue problem are tourist destinations and visitor numbers are likely to decline as media coverage of dengue outbreaks reaches those who might be considering holidaying in the countries concerned. The cost of care for people with dengue (particularly for the minority who develop life-threatening dengue haemorrhagic fever) adds to the burden. Control activities themselves are also of course costly.

It was estimated in 2005 that dengue typically costs Malaysia $13 million in treatment and vector control efforts annually, and that the output of 940,000 days of work is lost to the nation (1). From this study, it was concluded that: “One hospitalized case of dengue fever costs one-fifth of Malaysia’s per capita gross national product (GNP)”.

An attempt to quantify the economic impact of dengue in Panama was also recently published (2); researchers estimated that in 2005 the cost of care totalled $11.8 million and of control $5 million, amounting to $5.2 per head of population. This, however, excludes the impact on production, tourism etc.

While the human cost of dengue cannot be forgotten, the economic impact – especially at this time of global financial crisis – is an important consideration. An effective vaccine could achieve great economic savings as well as reducing suffering (3). The development of such a vaccine, to be combined with continuing vector control efforts, must therefore be accorded priority status by the international community.

References

1. Shepard D, Lum L, Suaya J (2005). International Health Economics Association Conference in Barcelona, Spain. Summary published on Innovations Report.

2. Armien B, Suaya JA, Quiroz E, Sah BK, Bayard V, Marchena L, Campos C, Shepard DS (2008). Clinical characteristics and national economic cost of the 2005 dengue epidemic in Panama. Am J Trop Med Hyg;79(3):364-371. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18784227

2. Shepard DS, Suaya JA, Halstead SB, Nathan MB, Gubler DJ, Mahoney RT, Wang DN, Meltzer MI (2004). Cost-effectiveness of a pediatric dengue vaccine. Vaccine; 22(9-10):1275-1280. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15003657

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