Socio-economic
research allows for the allocation of limited resources for the
greatest impact. Results are used by government policymakers, programme
managers, and LF advocates in endemic countries, as well as private,
bilateral and multilateral donors. Socio-economic research provides
information about efficiency in achieving results and programme
sustainability. It can be used to project future programme needs
and stimulate the development of new and better ways of carrying
out activities.
An Affordable
Elimination Programme
A feasible, effective, and inexpensive prevention strategy is already
in place with the administration of two oral drugs once a year.
Mass drug administration (MDA) campaigns distribute albendazole
plus diethylcarbamazine (DEC) or Mectizan® (ivermectin) to the
general population in endemic areas. Annual administration of the
drugs, for at least five years, is adequate to interrupt transmission
of the parasite that causes LF. Costs for MDAs vary among countries
but are typically much lower than $1.00 per person treated. An alternative
strategy is to fortify salt with DEC. Two years of DEC-fortified
salt consumption in over 80% of the endemic population will break
the transmission cycle.
Lymphatic
Filariasis Decreases Productivity and Income
LF is estimated to cause several billion US dollars a year in productivity
losses. Chronic LF patients in Orissa, India lost a total of 68
days of work per year, equivalent to 19% of the total working time
of the year. In fact, in all of India, lost productivity due to
LF is estimated at almost US$1billion a year. Entire communities
have changed productive pursuits to adapt to LF. These activities
often have lower economic returns but are less physically demanding.
Financial Burden
on Patients and Health Care Systems in addition to the lost productivity
and costs for medical treatment add an extra burden. For example,
three-quarters of chronic LF patients in rural communities in Orissa,
India sought treatment for their conditions. They spent an average
of US$8.70 a year on treatment, mostly on medicines, equivalent
to 2% of the average yearly wage.
LF creates a major drain
on government resources through medical care and treatment provided
by government hospitals and clinics. It is common to seek treatment
for acute attacks and hydrocele surgery creates additional costs.
In a hospital in Northern Ghana, 25% of all surgeries in 1998 were
for hydrocele.
Integration
of LF Elimination with Public Health Programmes to Reduce Costs
LF strategies can be integrated into other programmes to improve
cost effectiveness. Mass drug administration can be combined with
programmes to eliminate onchocerciasis and trachoma, to fight Vitamin
A deficiency, and with immunization programmes. DEC-salt fortification
to eliminate LF transmission can be combined with iodine and micronutrient
fortification schemes. In addition, development projects that reduce
mosquito breeding sites, improve housing and sanitation facilities
and stimulate economic development are likely to aid in reducing
the transmission of LF. Beyond integrating LF treatment with other
diseases, the drugs that prevent LF also eliminate intestinal worms,
providing an additional, immediate benefit. Annual treatment in
Haiti and elsewhere has shown dramatic and persistent reductions
in hookworm and roundworm infections, improving children’s
growth and nutrition.
Additional
Socio-Economic Information
Information on socio-economic consequences of the disease and the
benefits of national programmes to eliminate it is still forthcoming.
More studies are needed globally to better document the costs of
LF-related disability and the costs of different strategies to combat
LF. Click here to link to www.filariasis.us
for more information about ongoing socio-economic projects.
Following
are selected resources pertaining to the economics of lymphatic
filariasis:
Socio-Economic
Impact of LF and the Programme to Eliminate It: A short
document referencing the social and economic consequences of lymphatic
filariasis and the impact of the programme to eliminate the disease.
Available in English and French.
Bibliography
of Selected Socio-Economic Studies of LF: Abstracts from
over 30 studies examining the impact of LF worldwide.
LF:
Economic Aspects of the Disease and Programmes for its Elimination:
This article examines the economic evidence linking LF with
poverty.
The
Elimination of LF: A Strategy for Poverty Alleviation and Sustainable
Development : Written by Jaime Galvez Tan, former Chair
of the Global Alliance, this article discusses the impact of LF
and the programme to eliminate it in the Philippines. |
