Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries
Objectives COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMI...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-12-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/6/12/e005759.full |
| _version_ | 1797260155363000320 |
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| author | Edwine Barasa Mark Jit Mishal Khan Nicholas Davies Matthew Quaife Anna Vassall Sedona Sweeney Nichola Kitson Tim Baker Angela Kairu Rosalind Eggo Maryam Huda Nichola R Naylor Sergio Torres-Rueda Fiammetta Bozzani Nuru Saadi Carl Pearson Simon R Procter Marcus R Keogh-Brown Henning Tarp Jensen Raza Zaidi |
| author_facet | Edwine Barasa Mark Jit Mishal Khan Nicholas Davies Matthew Quaife Anna Vassall Sedona Sweeney Nichola Kitson Tim Baker Angela Kairu Rosalind Eggo Maryam Huda Nichola R Naylor Sergio Torres-Rueda Fiammetta Bozzani Nuru Saadi Carl Pearson Simon R Procter Marcus R Keogh-Brown Henning Tarp Jensen Raza Zaidi |
| author_sort | Edwine Barasa |
| collection | DOAJ |
| description | Objectives COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.Methods We used country-specific epidemiological projections from a dynamic transmission model to determine number of cases, hospitalisations and deaths over 1 year under four mitigation scenarios. We defined the health sector response for three base LMICs through guidelines and expert opinion. We calculated costs through local resource use and price data and extrapolated costs across 79 LMICs. Lastly, we compared cost estimates against gross domestic product (GDP) and total annual health expenditure in 76 LMICs.Results COVID-19 clinical management costs vary greatly by country, ranging between <0.1%–12% of GDP and 0.4%–223% of total annual health expenditure (excluding out-of-pocket payments). Without mitigation policies, COVID-19 clinical management costs per capita range from US$43.39 to US$75.57; in 22 of 76 LMICs, these costs would surpass total annual health expenditure. In a scenario of stringent social distancing, costs per capita fall to US$1.10–US$1.32.Conclusions We present the first dataset of COVID-19 clinical management costs across LMICs. These costs can be used to inform decision-making on priority setting. Our results show that COVID-19 clinical management costs in LMICs are substantial, even in scenarios of moderate social distancing. Low-income countries are particularly vulnerable and some will struggle to cope with almost any epidemiological scenario. The choices facing LMICs are likely to remain stark and emergency financial support will be needed. |
| first_indexed | 2024-04-24T23:20:50Z |
| format | Article |
| id | doaj.art-a7d1fce1daa74c9ea1ff8fad837430dd |
| institution | Directory Open Access Journal |
| issn | 2059-7908 |
| language | English |
| last_indexed | 2024-04-24T23:20:50Z |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj.art-a7d1fce1daa74c9ea1ff8fad837430dd2024-03-16T11:55:08ZengBMJ Publishing GroupBMJ Global Health2059-79082021-12-0161210.1136/bmjgh-2021-005759Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countriesEdwine Barasa0Mark Jit1Mishal Khan2Nicholas Davies3Matthew Quaife4Anna Vassall5Sedona Sweeney6Nichola Kitson7Tim Baker8Angela Kairu9Rosalind Eggo10Maryam Huda11Nichola R Naylor12Sergio Torres-Rueda13Fiammetta Bozzani14Nuru Saadi15Carl Pearson16Simon R Procter17Marcus R Keogh-Brown18Henning Tarp Jensen19Raza Zaidi20Health Economics Research Unit (HERU), KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK1 Department of Neurology, Imperial College Healthcare NHS Trust, London, UKDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Public Health, Karolinska Institutet, Stockholm, SwedenHealth Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKDepartment of Community Health Sciences, The Aga Khan University, Karachi, PakistanDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UKPakistan Ministry of National Health Services, Regulations, and Coordination, Islamabad, PakistanObjectives COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.Methods We used country-specific epidemiological projections from a dynamic transmission model to determine number of cases, hospitalisations and deaths over 1 year under four mitigation scenarios. We defined the health sector response for three base LMICs through guidelines and expert opinion. We calculated costs through local resource use and price data and extrapolated costs across 79 LMICs. Lastly, we compared cost estimates against gross domestic product (GDP) and total annual health expenditure in 76 LMICs.Results COVID-19 clinical management costs vary greatly by country, ranging between <0.1%–12% of GDP and 0.4%–223% of total annual health expenditure (excluding out-of-pocket payments). Without mitigation policies, COVID-19 clinical management costs per capita range from US$43.39 to US$75.57; in 22 of 76 LMICs, these costs would surpass total annual health expenditure. In a scenario of stringent social distancing, costs per capita fall to US$1.10–US$1.32.Conclusions We present the first dataset of COVID-19 clinical management costs across LMICs. These costs can be used to inform decision-making on priority setting. Our results show that COVID-19 clinical management costs in LMICs are substantial, even in scenarios of moderate social distancing. Low-income countries are particularly vulnerable and some will struggle to cope with almost any epidemiological scenario. The choices facing LMICs are likely to remain stark and emergency financial support will be needed.https://gh.bmj.com/content/6/12/e005759.full |
| spellingShingle | Edwine Barasa Mark Jit Mishal Khan Nicholas Davies Matthew Quaife Anna Vassall Sedona Sweeney Nichola Kitson Tim Baker Angela Kairu Rosalind Eggo Maryam Huda Nichola R Naylor Sergio Torres-Rueda Fiammetta Bozzani Nuru Saadi Carl Pearson Simon R Procter Marcus R Keogh-Brown Henning Tarp Jensen Raza Zaidi Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries BMJ Global Health |
| title | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_full | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_fullStr | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_full_unstemmed | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_short | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_sort | stark choices exploring health sector costs of policy responses to covid 19 in low income and middle income countries |
| url | https://gh.bmj.com/content/6/12/e005759.full |
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