Cost and benefits of controlling parasitic diseases

This paper is a review of the literature on the costs and benefits of control programs designed to combat major parasitic diseases, including protozoal and helminthic diseases. Over one hundred studies containing information on costs, health and/or economic effects of disease control were reviewed. Four principal definitions of cost-effectiveness are used in the literature: cost per person protection, per death averted, per case-year prevented and per healthy year gained; the latter two are regarded as the most useful when discussing parasitic diseases. The main findings that arise from this review are that substantial gaps exist in our knowledge about cost-effectiveness and benefit-cost ratios of projects directed against the diseases examined; there are large differences in cost-effectiveness between alternative techniques of control; and that a given technique is subject to wide variations in cost-effectiveness. Also, for any given technique of control, the cost per case-year prevented varies widely across different locations. The report recommends that when undertaking a new project of control, health authorities need to know whether they can expect a performance at the high or low end of the broad range covered by experience elsewhere.