Global eradication of measles: an epidemiologic and economic evaluation.

Tuesday, 29th of October 2013

[source]Journal of Infectious Diseases[|source]

The Measles Initiative (led by the American Red Cross, the Centers for Disease Control and Prevention, UNICEF, United Nations Foundation, and the WHO) is an international partnership committed to reducing measles-related deaths worldwide through increasing routine measles immunization coverage (RI) and conducting periodic campaigns known as supplementary immunization activities (SIAs). With the success of the measles-associated mortality reduction and elimination efforts thus far, WHO member states requested an assessment of whether global eradication of measles is programmatically, biologically, and economically feasible. 

 

In this report, the authors (1) estimated the cost and cost-effectiveness of measles eradication and intermediate goals of 95% and 98% mortality reduction, compared with the baseline scenario (the 90% measles-associated mortality reduction global goal) in 6 countries, and (2) extrapolated the analysis to the global level to determine cost and cost-effectiveness of global measles eradication. The report presents an estimated incremental aggregate discounted costs for eradication by 2020 during 2010–2050 to be $7.8 billion, comprised largely of vaccination services in nonelimination high-income countries where the delivery costs are greater, followed by costs in low-income countries . The authors conclude that reaching measles eradication by 2020 would be the most cost-effective measles mortality reduction scenario, both for the six countries and on a global basis. More details are available at:  http://jid.oxfordjournals.org/content/204/suppl_1/S98.long

 

 

Abstract

BACKGROUND: Measles remains an important cause of morbidity and mortality in children in developing countries. Due to the success of themeasles mortality reduction and elimination efforts thus far, the WHO has raised the question of whether global eradication of measles is economically feasible.

METHODS: The cost-effectiveness of various measles mortality reduction and eradication scenarios was evaluated vis-à-vis the current mortality reduction goal in six countries and globally. Data collection on costs of measles vaccination were conducted in six countries in four regions: Bangladesh, Brazil, Colombia, Ethiopia, Tajikistan, and Uganda. The number of measles cases and deaths were projected from 2010 to 2050 using a dynamic, age-structured compartmental model. The incremental cost-effectiveness ratios were then calculated for each scenario vis a vis the baseline.

RESULTS: Measles eradication by 2020 was the found to be the most cost-effective scenario, both in the six countries and globally. Eradicatingmeasles by 2020 is projected to cost an additional discounted $7.8 billion and avert a discounted 346 million DALYs between 2010 and 2050.

CONCLUSIONS: In conclusion, the study found that, compared to the baseline, reaching measles eradication by 2020 would be the most cost-effective measles mortality reduction scenario, both for the six countries and on a global basis.