Dataset Information

The Investment Case for Malaria Elimination in Thailand: A Cost-Benefit Analysis.

ABSTRACT: After a dramatic decline in the annual malaria incidence in Thailand since 2000, the Thai government developed a National Malaria Elimination Strategy (NMES) to end local malaria transmission by 2024. This study examines the expected costs and benefits of funding the NMES (elimination scenario) versus not funding malaria elimination programming (resurgence scenario) from 2017 to 2036. Two case projection approaches were used to measure the number of malaria cases over the study period, combined with a set of Thailand-specific economic assumptions, to evaluate the cost of a malaria case and to quantify the cost-benefit ratio of elimination. Model A projects cases based on national historical case data using a log-normal regression and change-point analysis model. Model B projects cases based on periodic Yala Province-level outbreak cycles and incorporating NMES political and programmatic goals. In the base case, both models predict that elimination would prevent 1.86-3.11 million malaria cases from 2017 to 2036, with full NMES implementation proving to be cost-saving in all models, perspectives, and scenarios, except for the health system-only perspective in the Model A base case and all perspectives in the Model A worst case. From the societal perspective, every 1 US dollars (US$) spent on the NMES would-depending on case projections used-potentially result in a considerable return on investment, ranging from US$ 2 to US$ 15. Although the two case projection approaches resulted in different cost-benefit ratios, both models showed cost savings and suggest that ending local malaria transmission in Thailand would yield a positive return on investment.

SUBMITTER: Sudathip P

PROVIDER: S-EPMC6553898 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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The Investment Case for Malaria Elimination in Thailand: A Cost-Benefit Analysis.

Sudathip Prayuth P Kongkasuriyachai Darin D Stelmach Rachel R Bisanzio Donal D Sine Jeffrey J Sawang Surasak S Kitchakarn Suravadee S Sintasath David D Reithinger Richard R

The American journal of tropical medicine and hygiene 20190601 6

After a dramatic decline in the annual malaria incidence in Thailand since 2000, the Thai government developed a National Malaria Elimination Strategy (NMES) to end local malaria transmission by 2024. This study examines the expected costs and benefits of funding the NMES (elimination scenario) versus not funding malaria elimination programming (resurgence scenario) from 2017 to 2036. Two case projection approaches were used to measure the number of malaria cases over the study period, combined ...[more]

PMID: 30994098

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Project description:BackgroundMalaria continues to be a public health problem in South Africa. While the disease is mainly confined to three of the nine provinces, most local transmissions occur because of importation of cases from neighbouring countries. The government of South Africa has reiterated its commitment to eliminate malaria within its borders. To support the achievement of this goal, this study presents a cost-benefit analysis of malaria elimination in South Africa through simulating different scenarios aimed at achieving malaria elimination within a 10-year period.MethodsA dynamic mathematical transmission model was developed to estimate the costs and benefits of malaria elimination in South Africa between 2018 and 2030. The model simulated a range of malaria interventions and estimated their impact on the transmission of Plasmodium falciparum malaria between 2018 and 2030 in the three endemic provinces of Limpopo, Mpumalanga and KwaZulu-Natal. Local financial, economic, and epidemiological data were used to calibrate the transmission model.ResultsBased on the three primary simulated scenarios: Business as Usual, Accelerate and Source Reduction, the total economic burden was estimated as follows: for the Business as Usual scenario, the total economic burden of malaria in South Africa was R 3.69 billion (USD 223.3 million) over an 11-year period (2018-2029). The economic burden of malaria was estimated at R4.88 billion (USD 295.5 million) and R6.34 billion (~ USD 384 million) for the Accelerate and Source Reduction scenarios, respectively. Costs and benefits are presented in midyear 2020 values. Malaria elimination was predicted to occur in all three provinces if the Source Reduction strategy was adopted to help reduce malaria rates in southern Mozambique. This could be achieved by limiting annual local incidence in South Africa to less than 1 indigenous case with a prediction of this goal being achieved by the year 2026.ConclusionsMalaria elimination in South Africa is feasible and economically worthwhile with a guaranteed positive return on investment (ROI). Findings of this study show that through securing funding for the proposed malaria interventions in the endemic areas of South Africa and neighbouring Mozambique, national elimination could be within reach in an 8-year period.

Project description:Background: The Asia-Pacific region has made significant progress against malaria, reducing cases and deaths by over 50% between 2010 and 2015. These gains have been facilitated in part, by strong political and financial commitment of governments and donors. However, funding gaps and persistent health system challenges threaten further progress. Achieving the regional goal of malaria elimination by 2030 will require an intensification of efforts and a plan for sustainable financing. This article presents an investment case for malaria elimination to facilitate these efforts. Methods: A transmission model was developed to project rates of decline of Plasmodium falciparum and Plasmodium vivax malaria and the output was used to determine the cost of the interventions that would be needed for elimination by 2030. In total, 80 scenarios were modelled under various assumptions of resistance and intervention coverage. The mortality and morbidity averted were estimated and health benefits were monetized by calculating the averted cost to the health system, individual households, and society. The full-income approach was used to estimate the economic impact of lost productivity due to premature death and illness, and a return on investment was computed. Results: The study estimated that malaria elimination in the region by 2030 could be achieved at a cost of USD 29.02 billion (range: USD 23.65-36.23 billion) between 2017 and 2030. Elimination would save over 400,000 lives and avert 123 million malaria cases, translating to almost USD 90 billion in economic benefits. Discontinuing vector control interventions and reducing treatment coverage rates to 50% will result in an additional 845 million cases, 3.5 million deaths, and excess costs of USD 7 billion. Malaria elimination provides a 6:1 return on investment. Conclusion: This investment case provides compelling evidence for the benefits of continued prioritization of funding for malaria and can be used to develop an advocacy strategy.

Project description:To determine the influence of the weight of the economic effectiveness evaluation criteria of the major investments of listed enterprises, and provide new management ideas for the development of the follow-up enterprises, firstly, the financial benefit evaluation system of investment projects is analyzed and constructed, and the specific evaluation process is analyzed. Then, on this basis, the evaluation index is refined; the basic structure of BP neural network (BPNN) is introduced, and genetic algorithm is used to improve BP neural network. The cost-benefit analysis model is constructed based on the improved BPNN. The listed company A is taken as an example to analyze its development data in recent years, and then the data of 10 listed companies are taken as the research object. Matlab simulation software is used to train and verify the improved BPNN model, analyze and predict the weight value of the financial benefit index of the investment projects of these 10 companies, and then determine the index to improve the financial benefit of the investment projects. Under the analysis of the development data of listed company A in the past 10 years, it is found that the indicators of the listed company's profitability per share, debt risk operation ability, development, and growth ability in the past 10 years are in relatively stable state. The principal component analysis of its 20 secondary sub-indexes is conducted based on the four primary indicators: profitability, debt risk, operational capacity, and development and growth. A total of eight principal components including return on equity (ROE), return on assets (ROA), (total asset turnover) TATO, turnover of account receivable (AR), asset-liability ratio, interest protection multiple, income growth rate, and year-on-year rate of increase for complete assets are extracted. The average error between the final output value, the actual value, and the expected value is 0.0304 and 0.0169, respectively. The weight coefficient of the monetary benefits evaluation indicator of investment items is calculated, and the computed results show that year-on-year rate of increase for complete assets, TOTA, ROA, turnover of total capital, and ROE are important indexes in the financial benefit evaluation of investment projects. It indicates that to improve the financial benefit of investment projects of listed enterprises, it is necessary to enhance the year-over-year growth degree of total properties and ROA.

Project description:BackgroundThailand is committed to eliminating malaria by 2024. From 2013 to 2020, the total number of malaria cases have decreased, from 37,741 to 4474 (an 88.1% reduction). However, infections with Plasmodium knowlesi, a monkey malarial pathogen that can also infect humans, have been increasingly observed. This study focused on the molecular analysis of P. knowlesi parasites causing malaria in Thailand.MethodsUnder Thailand's integrated Drug Efficacy Surveillance (iDES), which includes drug-resistance monitoring as part of routine case-based surveillance and responses, specimens were collected from malaria patients (n = 966) between 2018 and 2020. Thirty-one mono P. knowlesi infections (3.1%), most of which were from eastern and southern Thailand, were observed and confirmed by nested PCR assay and DNA sequencing. To evaluate whether these pathogens were from different lineages, cluster analysis based on seven microsatellite genotyping markers and the merozoite surface protein 1 (pkmsp1) gene was carried out. The P. knowlesi pyrimethamine resistance gene dihydrofolate reductase (pkdhfr) was sequenced and homology modelling was constructed.ResultsThe results of analysing the seven microsatellite markers and pkmsp1 sequence demonstrated that P. knowlesi parasites from eastern Thailand were of the same lineage as those isolated in Cambodia, while the parasites causing malaria in southern Thailand were the same lineage as those isolated from Malaysia. The sequencing results for the pkdhfr genes indicated the presence of two mutations, Arg34Leu and a deletion at position 105. On analysis with homology modelling, the two mutations were not associated with anti-malarial drug resistance.ConclusionsThis report compared the genetic populations of P. knowlesi parasites in Thailand from 2018 to 2020 and have shown similar lineages as those isolated in Cambodia and Malaysia of P. knowlesi infection in Thailand and demonstrated that the P. knowlesi parasites were of the same lineages as those isolated in Cambodia and Malaysia. The parasites were also shown to be sensitive to pyrimethamine.

Project description:A majority of smallholder farmers in sub-Saharan Africa (SSA) countries depend to a large extent on agriculture for food security and income. Efforts aimed at improving farm-related profitability are therefore important to improving livelihoods among smallholder farmers. In Ghana, for example, smallholder farmers that depend on agriculture face serious risks especially those related to climate change and variability and soil degradation. Notwithstanding these dangers, evidence of the published literature on how best to tackle these challenges is limited. Over the recent decades, however, there has been advancement by programs channelling resources into Climate-Smart Agricultural (CSA) practices to improving smallholder livelihoods and food security. The interest in advancing investment in CSA practices is a key pathway that has the potential to significantly reduce the negative effect of climate change and variability risks on smallholder farmers livelihoods. Investing in CSA practices is also a key pathway to improving farm yield per unit area. Consequently, smallholder farmers are adopting and implementing CSA practices. Despite that, a gap still exists on the profitability of undertaking such an investment, as this is key in determining the sustainability of CSA practices. On this basis, the present study undertook a detailed cost-benefit analysis (CBA) of seven CSA practices identified with smallholder farmers in the coastal savannah agro-ecological zone of Ghana. A total of 48 smallholder farmers that had adopted these practices were studied. Three CBA indicators namely the net present value (NPV), internal rate of return (IRR) and payback period (PP) were assessed for each of the seven CSA practices. The results showed that out of the seven CSA practices examined, six of them were profitably suitable for adoption and scaling up from the perspective of smallholder farmers as well as the public perspective. The finding from this study, therefore, fill the current information gap in the literature on the costs and benefits of adopting CSA practices on household livelihoods in Ghana. Such a finding is critical to the promotion and scaling up the adoption of CSA practices by smallholder farmers and serve as a basis of formulating appropriate guidelines and policies for supporting CSA practices.

Dataset Information

The Investment Case for Malaria Elimination in Thailand: A Cost-Benefit Analysis.

Publications

The Investment Case for Malaria Elimination in Thailand: A Cost-Benefit Analysis.

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