Article Text
Abstract
Background Onchocerciasis (river blindness) is endemic mostly in remote and rural areas in sub-Saharan Africa. The treatment goal for onchocerciasis has shifted from control to elimination in Africa. For investment decisions, national and global policymakers need evidence on benefits, costs and risks of elimination initiatives.
Methods We estimated the health benefits using a dynamical transmission model, and the needs for health workforce and outpatient services for elimination strategies in comparison to a control mode. We then estimated the associated costs to both health systems and households and the potential economic impacts in terms of income gains.
Results The elimination of onchocerciasis in Africa would avert 4.3 million–5.6 million disability-adjusted life years over 2013–2045 when compared with staying in the control mode, and also reduce the required number of community volunteers by 45–53% and community health workers by 56–60%. The elimination of onchocerciasis in Africa when compared with the control mode is predicted to save outpatient service costs by $37.2 million–$39.9 million and out-of-pocket payments by $25.5 million–$26.9 million over 2013–2045, and generate economic benefits up to $5.9 billion–$6.4 billion in terms of income gains.
Discussion The elimination of onchocerciasis in Africa would lead to substantial health and economic benefits, reducing the needs for health workforce and outpatient services. To realise these benefits, the support and collaboration of community, national and global policymakers would be needed to sustain the elimination strategies.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Footnotes
Handling editor Seye Abimbola.
Twitter Follow Fabrizio Tediosi @fabrizio2570
Contributors YEK and FT designed the study. WAS and MT contributed to development of the strategies modelled. WAS contributed to the health impact analysis. YEK and FT did the analysis and wrote the first draft of the report. All authors contributed to data interpretation and writing of the final report.
Funding This study is part of the Eradication Investment Case (EIC) of onchocerciasis, lymphatic filariasis and human African trypanosomiasis, grant #OPP1037660 of the Bill and Melinda Gates Foundation (BMGF). WAS was funded by the NTD Modelling Consortium supported by BMGF in partnership with the Task Force for Global Health.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.