Strengthening tuberculosis control overseas: who benefits?

Area of Science:

• Global Health Economics
• Infectious Disease Control
• Health Policy

Background:

• Tuberculosis (TB) remains a significant global health challenge, with funding gaps hindering effective control efforts.
• The economic impacts of TB control investments, especially across regions with varying disease burdens and population movement, require clarification.
• Population dynamics between Papua New Guinea (PNG) and Australia highlight the need to understand cross-border TB transmission and intervention consequences.

Purpose of the Study:

• To conduct an economic evaluation of Australian aid for expanding Directly Observed Treatment, Short Course (DOTS) in PNG's South Fly region.
• To assess the cost-effectiveness and economic benefits of increasing TB treatment coverage in a high-burden border area.

Main Methods:

• Utilized cost-utility analysis and cost-benefit analysis within economic models.
• Incorporated population movement dynamics between regions with differing TB prevalence, transmission rates, and treatment access.
• Drew upon World Health Organization (WHO) cost-benefit estimates and existing TB transmission models.

Main Results:

• An investment of $16 million to enhance DOTS coverage in the South Fly region is projected to yield a net present value of approximately $74 million for Australia.
• The cost per disability-adjusted life-year (DALY) averted in PNG is estimated at $7.
• The cost per quality-adjusted life-year (QALY) saved in PNG is estimated at $4.6.

Conclusions:

• Investments in TB control between regions with significant disparities in disease burden and health resources offer mutual economic and health benefits.
• Cross-border collaboration in TB control can lead to substantial health gains and economic advantages for all involved parties.
• These findings support the rationale for increased global investment in tuberculosis control programs, particularly in interconnected regions.