Challenges Related to the Economic Evaluation of the Direct and Indirect Benefits and the Costs of Disease Elimination and Eradication Efforts
by Kimberly M. Thompson and Radboud J. Duintjer Tebbens, Chapter 9 in Cochi SL and Dowdle WR (eds). Disease Eradication in the 21st Century: Implications for Global Health.  Cambridge, MA: MIT Press: 2011; 115-130. PDF


As health care costs continue to increase, economic evaluations of public health interventions play an increasingly important role in resource allocation decisions. In some cases, opportunities exist to eliminate and eradicate some diseases; such efforts typically require committing signifi cant amounts of fi nancial resources, with eradication also requiring international cooperation and coordination. Are investments in disease elimination or eradication worthwhile? How can we evaluate the economics of elimination and eradication efforts? What methodological issues might warrant special consideration? At a time when global health leaders continue to strive for global eradication of wild polioviruses types 1 and 3 (type 2 eradication occurred in 1999) and guinea worm (dracunculiasis), and to debate other eradication efforts related to measles and malaria, economic analyses can provide important context for the discussions. One of the most signifi cant challenges in conducting economic analyses relates to valuing the direct and indirect benefi ts of elimination nationally and eradication globally. This chapter discusses the requirements for disease elimination or eradication. It presents the methods and challenges and raises key questions associated with evaluating the economic benefi ts of disease elimination and eradication.

Note: This work builds on our decade of experience characterizing the risks, costs, and benefits of efforts to manage polioviruses.