Major economic benefits achieved by action to eliminate elephantiasis

5 Jul 2010

Paul Chinnock

Source: PLoS Neglected Tropical Diseases (see original article or PDF)

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Citation: Chu BK, Hooper PJ, Bradley MH, McFarland DA, Ottesen EA (2010). The Economic Benefits Resulting from the First 8 Years of the Global Programme to Eliminate Lymphatic Filariasis (2000–2007). PLoS Negl Trop Dis 4(6): e708.

The legs of an Indian woman who has been infected with LF for 30 years. [WHO/TDR/Chandran.]

Why should the world try to get rid of a disease like lymphatic filariasis (LF)? The primary motivation must always be humanitarian – 120 million people are infected with this appalling condition, also known as elephantiasis, and over 1.3 billion live in areas where they are at risk. Acute attacks of LF and the chronic effects of the disease have a major impact on the lives of those who are infected. However, increasingly, there is a need to justify efforts to eliminate the infectious diseases of poverty in terms of the economic benefits that might be achieved. A new study has found that, in the case of LF, these benefits are considerable.

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000 to guide endemic countries in implementing mass drug administration programmes against LF, making use of drugs donated by their manufacturers. Two years ago a study [1] quantified the health benefits achieved by GPELF in its first eight years: more than six million cases of hydrocoele and four million cases of lymphoedema were prevented, resulting in over 32 million disability-adjusted life years (DALYs) averted and many gains in quality of life. The latest study has focused on GPELF’s economic impact. The authors argue that such an evaluation is important, “not only to justify the resources invested in the GPELF but also to more fully understand the Programme’s overall impact on some of the poorest endemic populations”.

The researchers made use of multiple data sources, including published literature and databases from WHO, the International Monetary Fund, and the International Labour Organization. Most of their data came from India and sub-Saharan Africa, where three-quarters of LF cases are to be found. They quantified the number of clinical manifestations averted and then analysed the savings associated with this in the context of direct treatment costs, indirect costs of lost labour, and costs to the health system to care for those affected.

From their analysis, they estimated that $21.8 billion were gained by individuals benefitting from the first eight years of the Global Programme. $2.3 billion of this figure was the result of preventing nearly three million newborns and other individuals from acquiring LF as a result of their being born into areas freed of its transmission. The majority of the gains are the result of making it possible for people to earn money, which their poor health, due to LF, would have otherwise have prevented them from doing.

An additional $2.2 billion were saved by the health systems of endemic countries, because of reduced use of health services.

Treating LF-endemic populations is possible at very low cost, particularly because of major drug donations from two pharmaceutical companies. As a result, massive economic benefits can be achieved. The authors argue that their findings strengthen the case that LF elimination is a “best buy’ in global health”.

The economic impact will be even greater when the GPELF is expanded to reach those LF-endemic areas which have yet to be reached by the programme. This will not be easy, as many of these areas are in some of the poorest and most remote parts of Africa. However, this study shows that the benefits of programme expansion will outweigh the costs.

Not all of the infectious diseases of poverty can be eliminated using the mass administration of drugs that have been made available without cost by their manufacturers. Nevertheless, these findings make clear the extent to which disease control can result in economic gains.

References

Ottesen EA, Hooper PJ, Bradley M, Biswas G (2008) The Global Programme to Eliminate Lymphatic Filariasis: Health Impact after 8 Years. PLoS eNTDs 317. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18841205

2010 Chu et al

Source

Title:
The economic benefits resulting from the first 8 years of the Global Programme to Eliminate Lymphatic Filariasis (2000-2007).

Authors:
Chu BK, Hooper PJ, Bradley MH, McFarland DA, Ottesen EA

References:
PLoS Negl Trop Dis 2010: Vol. 4 no. 6, pp. e708

Abstract:
Between 2000-2007, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) delivered more than 1.9 billion treatments to nearly 600 million individuals via annual mass drug administration (MDA) of anti-filarial drugs (albendazole, ivermectin, diethylcarbamazine) to all at-risk for 4-6 years. Quantifying the resulting economic benefits of this significant achievement is important not only to justify the resources invested in the GPELF but also to more fully understand the Programme's overall impact on some of the poorest endemic populations.To calculate the economic benefits, the number of clinical manifestations averted was first quantified and the savings associated with this disease prevention then analyzed in the context of direct treatment costs, indirect costs of lost-labor, and costs to the health system to care for affected individuals. Multiple data sources were reviewed, including published literature and databases from the World Health Organization, International Monetary Fund, and International Labour OrganizationAn estimated US$21.8 billion of direct economic benefits will be gained over the lifetime of 31.4 million individuals treated during the first 8 years of the GPELF. Of this total, over US$2.3 billion is realized by the protection of nearly 3 million newborns and other individuals from acquiring lymphatic filariasis as a result of their being born into areas freed of LF transmission. Similarly, more than 28 million individuals already infected with LF benefit from GPELF's halting the progression of their disease, which results in an associated lifetime economic benefit of approximately US$19.5 billion. In addition to these economic benefits to at-risk individuals, decreased patient services associated with reduced LF morbidity saves the health systems of endemic countries approximately US$2.2 billion.MDA for LF offers significant economic benefits. Moreover, with favorable program implementation costs (largely a result of the sustained commitments of donated drugs from the pharmaceutical industry) it is clear that the economic rate of return of the GPELF is extremely high and that this Programme continues to prove itself an excellent investment in global health.

PMID: 20532228
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