GLOBAL ERADICATION OF MEASLES: AN EPIDEMIOLOGIC AND ECONOMIC EVALUATION

Sunday, 23rd of February 2014

[source]Journal of Infectious Diseases[|source]

Because of 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. Several factors work in favor of measles eradication: a) humans are the only hosts, b) measles vaccine is highly efficacious, c) immunity resulting from infection and/or vaccination is very durable, and d) tested experience of interrupted measles transmission in large geographical block of PAHO.
In this report, the authors (1) estimate 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) extrapolate this analysis to the global level to determine cost and cost-effectiveness of global measles eradication. The report documents that eradicating measles by 2020 remains cost-effective under many conditions. More details are accessible 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 the measles 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 was 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. Eradicating measles 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.