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Response Questions Part A To B A. Include the major problem of this article B. Include the specific question you are tıying to answer of this article Author summary Human African trypanosomiasis, leprosy, visceral leishmaniasis and Chagas disease are neglected tropical disea (NTDs) controlled or eliminated by innovative and intensified disease management (IDM). We estimated the economic impact of meeting the 2020 targets defined by the WHO for NTD controlVelimination, reinforced by the tematic literature review identified infomation on productivity 1 disease cases with estimated productivity losses and OPPs resulting from the diseases, from the perspective affected individuals. Very little information about OPPs and productivity loss due to NTDs was found in the literature. The total global productivity gained by reaching the goals for the four IDM-NTDs was IS 23.1 billion in the period 2011-2020 and IS 35.9 billion in the period 2021-2030. The reduction in OPPs was IS 14 billion and IS 18 billion for the same periods. In order to estimate the economic impact of meeting the London declaration targets regarding four IDM-NTDs, we had to combine data from various sources, heterogeneous background, and variable quality. Nevertheless, based on conservative assumptions and subsequent uncertainty analyses, we estimate that th benefits of achieving the targets are nearly double the required investments by endemic country governments and their development partners to reach the 2020 target Introduction Disadvantaged populations from low-and middle-income countries (LMICs) often have to deal with the health and economic con sequences of neglected tropical diseases (NTDs), which can often aggravate their stuggles to avoid poverty. Chagas disease, human African trypanosomiasis (HAT), leprosy and visceral leishmaniasis (VL) are still di fl(1.li and can Iv ies maaungre and $15 anlahk:飶9馥les are limernitalles fa tuse 10. 120 yen 憱:ales s we inve eet mîml programmes. They should be controlled or eliminated by “innovative and intensified disease management” (IDM), as promoted by the World Health Organization (WHO). The populations affected by them frequently live in rural or remote areas, thereby limiting access to diagnosis and treatment of both the disease as well as the disabilities they Efforts of many private and public sector organizations have aimed at increasing the attention, as well as research and funding, given to NTDs. One of the results was the 2012 London Declaration, based on targets set out in the WHO Roadmap for the control and elimination of 10 NTDs by the year 2020 Compared to studies of the epidem iology and health consequences of NTDs, relatively few studies have examined the impact of NTDs on the productivity and out-of-pocket payments (OPPs) of individuals, households communities and countries. There is clear evidence that health improvements positively influence economic welfare and vice-versa. In this sense, apart from addressing the human fundamental right to the highest attainable standard of health, controlling and eliminating NTDs would also have a direct and sustainable effect on the economic growth and financial welfare of the affected populations, and consequently lead to greater national and global prosperity. Advances in understanding the economic consequences of NTDs could help to further encourage prevention and control actions, assuring funders and policymakers that resources committed to these efforts are a good investment, or at least resulting in increased health policy dialogu We estimated the economic benefits of reaching the 2020 WHO targets for four IDM diseases: Chagas disease, human African trypanosomiasis, leprosy and visceral leishm aniasis, which meant estimating how much of the economic loss faced by affected individuals due to productivity loss and out-of-pocket payments secondary to these diseases would be avoided by reaching these targets.
Methods General approach and study design The general approach to estimate the economic benefits is the same as the one used to calculate the benefits of achieving the 2020 WHO targets for NTDs controlled or eliminated by preventive chemotherapy (PCT) described by Redekop et al. This approach follows the concepts used by Chu et al., and a conceptual framework can be seen as Supporting Information 1 The Global Burden of Disease Study (GBD) is the most extensive worldwide observational epidemiological study up to now. Mortality and morbidity from major diseases, injuries and risk factors to health are described at the global, national and regional levels. The GBD-2010 data of prevalent cases of the NTDs included in the London Declaration for the years 1990 and 2010 were used years. They were obtained by interpolating between 1990 and 2010, as presented by de Vlas et al. The prevalent cases until 2030 were estimated by extrapolation under the assumption that the 2020 WHO Roadmap targets would be met and sustained beyond 2020. For each GBD disease sequela, a comparison is made between a counterfactual scenario (which assumed that the epidemiological situation from 1990 regarding NTDs would continue unabated and that the number of cases would increase as a function of overall population growth) and a target achievement scenario (that considers the 2020 targets described in the 2012 London Declaration and described by the WHO being achieved). as starting points for the calculation of the estimates for other We calculated the base case estimates of the benefit for the period between 2011 and 2030 (i.e., the period between ten years before and ten years after the target achievement) instead of the entire period from 1990 to 2030. The economic benefit was calculated by subtracting the costs for the target achievement scenario from the costs of the counterfactual scenario. The economic benefit of each country was combined in order to provide region and global estimates of the economic benefit International USS (constant 2005 dollars) were used to express all estimates in this study. It is a hypothetical unit of currency that has the same purchasing power as the U.S. dollar has in the United States at a given point in time (in this case 2005). It is estimated using purchasing power parity (PPP) exchange rate, defined as the amount of a country’s currency needed to purchase the same amounts of goods and services in the domestic market as one U.S dollar would buy in the United States. It is a valid measure frequently used to compare estim ates between countries. Constant discounting at 3% was applied to both productivity loss and OPPs, using the base year of 2010 Discounting is a mathematical operation to adjust future costs and effects of health-care interventions to the “present value”. When calculating for discounting, for each year (n) in the future the value of costs or benefits is multiplied by (1D)”) D being the discount rate Following WHO’s recommendations, the economic benefits from prevented productivity loss and out-of-pocket payments were reported separately. All calculations were performed using Microsoft Excel (version 2010) Perspective Like previous NTD economic impact studies, we used the human capital approach in our study with the perspective of the individual affected by an NTD to analyze the economic costs per GBD sequela, sex and country The WHO Guide to Identifying the Economic Consequences of Disease and Injury distinguishes the following cost categories when calculating the microeconomic impact of disease and injury: expenditures on health; labour and productivity losses; effects on human, physical and financial capital fomation; non-market impacts such as leisure or caregiver time. We only included the first two in our analyses, incurred by affected individuals during illness in low- and middle-income countries.
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