Elsevier

Vaccine

Volume 21, Issues 7–8, 30 January 2003, Pages 702-705
Vaccine

Costs and benefits of polio eradication: a long-run global perspective

https://doi.org/10.1016/S0264-410X(02)00584-4Get rights and content

Abstract

Pre-vaccination polio incidence rates in USA and Italy were used to predict the cases that would have occurred in the world for the years 1970–2050 in the absence of immunization. Globally, polio program will cost about $ 67 billion if vaccination is discontinued after 2010. The medical care cost savings achieved will be more than $ 128 billions, implying that polio eradication activities actually pay for itself in the longer run. In addition to the cost savings, the program will prevent 855,000 deaths, 4 million paralysis cases and 40 million disability adjusted life years (DALYs) over the years 1970–2050.

Introduction

Polio eradication program has shown significant progress since 1985. By the year 2001, the number of endemic polio transmission countries declined to only 20 from about 50 in 1998. The current plan is to make the world free from wild polio transmission by the year 2005. At this juncture in the history of polio vaccination and eradication, it will be useful to examine the costs incurred by the world in this effort and the real benefits derived from these activities. Such an analysis will help design, implement and evaluate future disease eradication efforts. The quantitative estimates of costs and benefits derived from this analysis will also be useful for advocacy purposes.

In fact, polio eradication activities may appear very costly for low-income countries of the world if a short time horizon is considered although total benefits derived outweighs total costs in the longer run. The analysis of resource requirements of polio vaccination and eradication will help analysts to design long-term resource mobilization strategies for future disease eradication programs.

The purpose of this paper is to examine the global economic costs and benefits of polio vaccination and eradication by six geographic regions of the world.

Section snippets

Methodology

To analyze the global health effects and costs of polio vaccination and eradication program, we have started from the World Health Organization (WHO) defined six regions of the world as the unit of analysis. The regions are: African region (AFR), region of the Americas (AMR), eastern Mediterranean region (EMR), European region (EUR), south-east Asia region (SEAR) and western Pacific region (WPR). Aggregating the country-level data on population and age distribution of population, regional

The empirical results

Cost of polio vaccination per dose varies from $ 1.50 in SEAR to $ 7.65 in the AMR. The cost per dose in a region is actually a weighted average of cost per dose in low-income, middle-income, upper-middle-income and high-income countries using the proportion of population in these four categories of countries as the weights. The cost of supplemental immunization (National Immunization Days, mop-up, etc.) also varies significantly for developed and developing countries. Again, weighted average

Conclusions and policy implications

For AMR and EUR, polio vaccination and eradication program is actually cost saving. Therefore, the net cost per DALY saved or mortality prevented are all negative implying that for these regions of the world, it is irrational not to adopt polio vaccination and eradication. The medical care costs saved by preventing polio and the associated paralysis cases is more than two to three times the cost of conducting the vaccination program over the long-run. The cost-effectiveness ratios for polio

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