OBJECTIVE: To cross-validate the global cost of scaling up child survival interventions to achieve the fourth Millennium Development Goal (MDG4) as estimated by the World Health Organization (WHO) in 2007 by using the latest country-provided data and new assumptions. METHODS: After the main cost categories for each country were identified, validation questionnaires were sent to 32 countries with high child mortality. Publicly available estimates for disease incidence, intervention coverage, prices and resources for individual-level and programme-level activities were validated against local data. Nine updates to the 2007 WHO model were generated using revised assumptions. Finally, estimates were extrapolated to 75 countries and combined with cost estimates for immunization and malaria programmes and for programmes for the prevention of mother-to-child transmission of the human immunodeficiency virus (HIV). FINDINGS: Twenty-six countries responded. Adjustments were largest for system- and programme-level data and smallest for patient data. Country-level validation caused a 53% increase in original cost estimates (i.e. 9 billion 2004 United States dollars [US$]) for 26 countries owing to revised system and programme assumptions, especially surrounding community health worker costs. The additional effect of updated population figures was small; updated epidemiologic figures increased costs by US$ 4 billion (+15%). New unit prices in the 26 countries that provided data increased estimates by US$ 4.3 billion (+16%). Extrapolation to 75 countries increased the original price estimate by US$ 33 billion (+80%) for 2010-2015. CONCLUSION: Country-level validation had a significant effect on the cost estimate. Price adaptations and programme-related assumptions contributed substantially. An additional 74 billion US$ 2005 (representing a 12% increase in total health expenditure) would be needed between 2010 and 2015. Given resource constraints, countries will need to prioritize health activities within their national resource envelope.
OBJECTIVE: To cross-validate the global cost of scaling up child survival interventions to achieve the fourth Millennium Development Goal (MDG4) as estimated by the World Health Organization (WHO) in 2007 by using the latest country-provided data and new assumptions. METHODS: After the main cost categories for each country were identified, validation questionnaires were sent to 32 countries with high child mortality. Publicly available estimates for disease incidence, intervention coverage, prices and resources for individual-level and programme-level activities were validated against local data. Nine updates to the 2007 WHO model were generated using revised assumptions. Finally, estimates were extrapolated to 75 countries and combined with cost estimates for immunization and malaria programmes and for programmes for the prevention of mother-to-child transmission of the human immunodeficiency virus (HIV). FINDINGS: Twenty-six countries responded. Adjustments were largest for system- and programme-level data and smallest for patient data. Country-level validation caused a 53% increase in original cost estimates (i.e. 9 billion 2004 United States dollars [US$]) for 26 countries owing to revised system and programme assumptions, especially surrounding community health worker costs. The additional effect of updated population figures was small; updated epidemiologic figures increased costs by US$ 4 billion (+15%). New unit prices in the 26 countries that provided data increased estimates by US$ 4.3 billion (+16%). Extrapolation to 75 countries increased the original price estimate by US$ 33 billion (+80%) for 2010-2015. CONCLUSION: Country-level validation had a significant effect on the cost estimate. Price adaptations and programme-related assumptions contributed substantially. An additional 74 billion US$ 2005 (representing a 12% increase in total health expenditure) would be needed between 2010 and 2015. Given resource constraints, countries will need to prioritize health activities within their national resource envelope.
Authors: Lara J Wolfson; François Gasse; Shook-Pui Lee-Martin; Patrick Lydon; Ahmed Magan; Abdelmajid Tibouti; Benjamin Johns; Raymond Hutubessy; Peter Salama; Jean-Marie Okwo-Bele Journal: Bull World Health Organ Date: 2008-01 Impact factor: 9.408
Authors: Igor Rudan; Joy Lawn; Simon Cousens; Alexander K Rowe; Cynthia Boschi-Pinto; Lana Tomasković; Walter Mendoza; Claudio F Lanata; Arantxa Roca-Feltrer; Ilona Carneiro; Joanna A Schellenberg; Ozren Polasek; Martin Weber; Jennifer Bryce; Saul S Morris; Robert E Black; Harry Campbell Journal: Lancet Date: 2005 Jun 11-17 Impact factor: 79.321
Authors: Jennifer Bryce; Robert E Black; Neff Walker; Zulfiqar A Bhutta; Joy E Lawn; Richard W Steketee Journal: Lancet Date: 2005 Jun 25-Jul 1 Impact factor: 79.321
Authors: Zulfiqar A Bhutta; Tahmeed Ahmed; Robert E Black; Simon Cousens; Kathryn Dewey; Elsa Giugliani; Batool A Haider; Betty Kirkwood; Saul S Morris; H P S Sachdev; Meera Shekar Journal: Lancet Date: 2008-02-02 Impact factor: 79.321
Authors: David R Marsh; Kate E Gilroy; Renee Van de Weerdt; Emmanuel Wansi; Shamim Qazi Journal: Bull World Health Organ Date: 2008-05 Impact factor: 9.408
Authors: Michel Garenne; Douladel Willie; Bernard Maire; Olivier Fontaine; Roger Eeckels; André Briend; Jan Van den Broeck Journal: Public Health Nutr Date: 2009-03-02 Impact factor: 4.022