Cost-effectiveness of blindness prevention by the Onchocerciasis Control Programme in Upper Volta

The article presents a cost-effectiveness analysis of the Onchocerciasis Control Programme in Upper Volta. The analysis uses a new approach to the measurement of health project effectiveness, by considering the number of healthy years of life added by the prevention of permanent disability and premature death attributable to onchocercal blindness. The approach emphasizes the central role of social value judgements in allocating health resources-in particular the relative weights assigned to preventing disability and postponing death, present and future health benefits, and health gains among productive and non-productive individuals. The quantitative results yield the following cost-effectiveness estimates for blindness prevention through onchocerciasis control: US$20 per year of healthy life and per productive year of healthy life added, and US$150 per discounted year of healthy life and per discounted productive year of healthy life added. As an illustrative example, a comparison is made with estimates of the cost-effectiveness of measles immunization.