Cost-benefit analysis of controlling rabies: placing economics at the heart of rabies control to focus political will.

Rabies is an economically important zoonosis. This paper describes the extent of the economic impacts of the disease and some of the types of economic analyses used to understand those impacts, as well as the trade-offs between efforts to manage rabies and efforts to eliminate it. In many cases, the elimination of rabies proves more cost-effective over time than the continual administration of postexposure prophylaxis, animal testing and animal vaccination. Economic analyses are used to inform and drive policy decisions and focus political will, placing economics at the heart of rabies control.

La rage est une zoonose importante au plan économique. Les auteurs décrivent la portée de l'impact économique de la rage et présentent quelques modèles d'analyse économique utilisés pour comprendre ces effets ; ils analysent également les compromis à trouver entre les efforts consacrés à la gestion de la rage et ceux dédiés à son élimination. Dans bien des cas, il est plus rentable sur le long terme d'éliminer la rage que de procéder à la gestion continue de la prophylaxie post-exposition chez l'homme et au dépistage et à la vaccination des animaux. Les analyses économiques servent à documenter et à orienter les décisions concernant les mesures à prendre afin de mobiliser la volonté politique nécessaire, en plaçant l'économie au coeur de la lutte contre la rage.

La rabia es una zoonosis que reviste importancia económica. Los autores exponen la magnitud del impacto económico de la enfermedad y algunas de las modalidades de análisis económico utilizadas para aprehender esas consecuencias, así como el juego de equilibrios entre las medidas de gestión de la rabia y las actividades destinadas a eliminarla. En muchos casos, la eliminación de la enfermedad ofrece a la larga mayor eficacia, en relación con el costo, que la continua labor de administración de profilaxis tras exposición, realización de pruebas en animales y vacunación de estos. Los análisis económicos sirven para fundamentar y encauzar las decisiones de planificación y para aglutinar la voluntad política, haciendo de los aspectos económicos un eje de la lucha contra la rabia.

Towards canine rabies elimination: Economic comparisons of three project sites.

An appreciation of the costs of implementing canine rabies control in different settings is important for those planning new or expanded interventions. Here we compare the costs of three canine rabies control projects in South Africa, the Philippines and Tanzania to identify factors that influence the overall costs of rabies control efforts. There was considerable variation in the cost of vaccinating each dog, but across the sites these were lower where population density was higher, and later in the projects when dog vaccination coverage was increased. Transportation costs comprised a much higher proportion of total costs in rural areas and where house-to-house vaccination campaigns were necessary. The association between the cost of providing PEP and human population density was less clear. The presence of a pre-existing national rabies management programme had a marked effect on keeping infrastructure and equipment costs for the project low. Finally, the proportion of the total costs of the project provided by the external donor was found to be low for the projects in the Philippines and South Africa, but likely covered close to the complete costs of the project in Tanzania. The detailed economic evaluation of three recent large-scale rabies control pilot projects provides the opportunity to examine economic costs across these different settings and to identify factors influencing rabies control costs that could be applied to future projects.