Economics of zoonoses surveillance in a 'One Health' context: an assessment of Campylobacter surveillance in Switzerland.

Cross-sectorial surveillance and general collaboration between the animal and the public health sectors are increasingly recognized as needed to better manage the impacts of zoonoses. From 2009, the Swiss established a Campylobacter mitigation system that includes human and poultry surveillance data-sharing within a multi-sectorial platform, in a 'One Health' approach. The objective of this study was to explore the economics of this cross-sectorial approach, including surveillance and triggered interventions. Costs and benefits of the One Health and of the uni-sectorial approach to Campylobacter surveillance were identified using an economic assessment framework developed earlier. Cost information of surveillance activities and interventions was gathered and disability-adjusted life years (DALYs) associated with the disease estimated for 2008 and 2013. In the first 5 years of this One Health approach to Campylobacter mitigation, surveillance contributed with information mainly used to perform risk assessments, monitor trends and shape research efforts on Campylobacter. There was an increase in costs associated with the mitigation activities following integration, due mainly to the allocation of additional resources to research and implementation of poultry surveillance. The overall burden of campylobacteriosis increased by 3·4-8·8% to 1751-2852 DALYs in 2013. In the timing of the analysis, added value associated with this cross-sectorial approach to surveillance of Campylobacter in the country was likely generated through non-measurable benefits such as intellectual capital and social capital.

Achieving an optimal allocation of resources for animal health surveillance, intervention and disease mitigation.

The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.

L'économie de la santé animale a pour rôle primordial d'étayer la prise de décisions en définissant les meilleurs investissements en santé animale. Les activités de surveillance de la santé animale permettent de réunir les informations nécessaires pour guider les interventions. Par conséquent, il est nécessaire d'évaluer en même temps les investissements dans la surveillance et ceux dans les interventions. Les auteurs exposent les différents cadres théoriques et méthodologiques permettant d'évaluer et d'optimiser l'utilisation des ressources allouées à la surveillance et aux interventions et en font ressortir l'interdépendance technique. Les cadres présentés mettent en rapport les investissements dans la santé avec les pertes dues aux maladies et définissent les relations entre les ressources allouées à la surveillance et celles allouées aux interventions. La surveillance et les interventions sont généralement considérées comme des substitus tecniques, dans la mesure où toute augmentation des investissements dans la surveillance réduit d'autant le volume des ressources allouées aux interventions, pour un bénéfice équivalent. Les auteurs examinent également les approches utilisées pour quantifier les externalités ainsi que les impacts non monétaires. Enfin, ils décrivent plusieurs types d'évaluations économiques courantes, dont l'optimisation, l'acceptabilité et les analyses du moindre coût.

La economía de la sanidad animal tiene por función básica fundamentar la adopción de decisiones por el expediente de determinar cuáles son las inversiones óptimas desde el punto de vista zoosanitario. La vigilancia zoosanitaria genera información con la cual orientar las intervenciones. Por consiguiente, es necesario evaluar conjuntamente las inversiones en vigilancia y las destinadas a intervenciones. Los autores examinan los diferentes métodos y marcos teóricos que se han elaborado para evaluar y optimizar el gasto de recursos en labores de vigilancia y en intervenciones, así como su interdependencia técnica. En este sentido, presentan una serie de marcos que definen la relación entre inversiones en sanidad y pérdidas por enfermedades y la relación entre recursos para vigilancia y recursos para intervenciones. En general se considera que la vigilancia y las intervenciones son técnicamente interdependientes, toda vez que una mayor inversión en vigilancia reduce la cuantía de los recursos para intervenciones que hacen falta para obtener el mismo beneficio. Los autores también reflexionan sobre los métodos empleados para cuantificar los factores externos (externalidades) y las repercusiones no monetarias. Por último, describen los tipos más frecuentes de evaluación económica, como los de optimización, aceptabilidad o análisis del costo mínimo.

Cost-effectiveness analysis: adding value to assessment of animal health welfare and production.

Cost-effectiveness analysis (CEA) has been extensively used in economic assessments in fields related to animal health, namely in human health where it provides a decision-making framework for choices about the allocation of healthcare resources. Conversely, in animal health, cost-benefit analysis has been the preferred tool for economic analysis. In this paper, the use of CEA in related areas and the role of this technique in assessments of animal health, welfare and production are reviewed. Cost-effectiveness analysis can add further value to these assessments, particularly in programmes targeting animal welfare or animal diseases with an impact on human health, where outcomes are best valued in natural effects rather than in monetary units. Importantly, CEA can be performed during programme implementation stages to assess alternative courses of action in real time.

Economic Assessment of Zoonoses Surveillance in a 'One Health' Context: A Conceptual Framework.

Collaboration between animal and public health sectors has been highlighted as a means to improve the management of zoonotic threats. This includes surveillance systems for zoonoses, where enhanced cross-sectoral integration and sharing of information are seen as key to improved public health outcomes. Yet, there is a lack of evidence on the economic returns of such collaboration, particularly in the development and implementation of surveillance programmes. The economic assessment of surveillance in this context needs to be underpinned by the understanding of the links between zoonotic disease surveillance in animal populations and the wider public health disease mitigation process and how these relations impact on the costs and benefits of the surveillance activities. This study presents a conceptual framework of these links as a basis for the economic assessment of cross-sectoral zoonoses surveillance with the aim of supporting the prioritization of resource allocation to surveillance. In the proposed framework, monetary, non-monetary and intermediate or intangible cost components and benefit streams of three conceptually distinct stages of zoonotic disease mitigation are identified. In each stage, as the final disease mitigation objective varies so does the use of surveillance information generated in the animal populations for public health decision-making. Consequently, the associated cost components and benefit streams also change. Building on the proposed framework and taking into account these links, practical steps for its application are presented and future challenges are discussed.