Cost-Effectiveness Analysis of Humanitarian Relief Interventions: Visceral Leishmaniasis Treatment in the Sudan.
AffiliationMédecins Sans Frontières, Amsterdam, The Netherlands.
MetadataShow full item record
JournalHealth Policy and Planning
AbstractSpending by aid agencies on emergencies has quadrupled over the last decade, to over US$6 billion. To date, cost-effectiveness has seldom been considered in the prioritization and evaluation of emergency interventions. The sheer volume of resources spent on humanitarian aid and the chronicity of many humanitarian interventions call for more attention to be paid to the issue of 'value for money'. In this paper we present data from a major humanitarian crisis, an epidemic of visceral leishmaniasis (VL) in war-torn Sudan. The special circumstances provided us, in retrospect, with unusually accurate data on excess mortality, costs of the intervention and its effects, thus allowing us to express cost-effectiveness as the cost per Disability Adjusted Life Year (DALY) averted. The cost-effectiveness ratio, of US$18.40 per DALY (uncertainty range between US$13.53 and US$27.63), places the treatment of VL in Sudan among health interventions considered 'very good value for money' (interventions of less than US$25 per DALY). We discuss the usefulness of this analysis to the internal management of the VL programme, the procurement of funds for the programme, and more generally, to priority setting in humanitarian relief interventions. We feel that in evaluations of emergency interventions attempts could be made more often to perform cost-effectiveness analyses, including the use of DALYs, provided that the outcomes of these analyses are seen in the broad context of the emergency situation and its consequences on the affected population. This paper provides a first contribution to what is hoped to become an international database of cost-effectiveness studies of health interventions during relief operations, which use a comparable measure of health outcome such as the DALY.
PublisherPublished by Oxford University Press
DescriptionTo access this article, click on "Additional Links"
- The cost-effectiveness of forty health interventions in Guinea.
- Authors: Jha P, Bangoura O, Ranson K
- Issue date: 1998 Sep
- Breastfeeding promotion and priority setting in health.
- Authors: Horton S, Sanghvi T, Phillips M, Fiedler J, Perez-Escamilla R, Lutter C, Rivera A, Segall-Correa AM
- Issue date: 1996 Jun
- Royal Society of Tropical Medicine and Hygiene joint meeting with Médecins Sans Frontières at Manson House, London, 20 March 2003: field research in humanitarian medical programmes. Médecins Sans Frontières interventions against kala-azar in the Sudan, 1989-2003.
- Authors: Ritmeijer K, Davidson RN
- Issue date: 2003 Nov-Dec
- Cost-effectiveness projections of single and combination therapies for visceral leishmaniasis in Bihar, India.
- Authors: Olliaro P, Darley S, Laxminarayan R, Sundar S
- Issue date: 2009 Aug
- A reassessment of the cost-effectiveness of water and sanitation interventions in programmes for controlling childhood diarrhoea.
- Authors: Varley RC, Tarvid J, Chao DN
- Issue date: 1998