Economic burden of diarrheal diseases and effect of vaccination – Experience from a Lower Middle Income (LMI) country 

Diarrheal diseases are a major threat to human health and still leading cause of mortality and morbidity worldwide. Although the burden of the diarrheal diseases is much lower in developed countries, it is a significant public health problem in low and middle-income countries like Bangladesh. Though diarrhoea is preventable and managed with low-cost interventions, it is still the leading cause of morbidity for patients who sought care from public hospitals in Bangladesh, indicating that significant resources are consumed in treating those patients. 

The promise of vaccination

Vaccination against vaccine preventable diseases through the Expanded Program on Immunisation (EPI) is one of the most cost-effective health investments.  Although in recent years, many new vaccines have been developed against many infectious disease but most developing countries do not have the means of accessing, evaluating, and implementing these newly-developed vaccines. As a result, a large part of the population, mainly children, who were in most need, do not have access to the new vaccines. These new vaccines may appear more expensive compared existing vaccines as some of the targeted diseases are relatively ‘hidden’ and, therefore, there is little public or political demand.  

The importance of cost-effectiveness

Cost-effectiveness is particularly important because of the need to determine the level of resources required in the future to improve immunisation programmes, to cover the costs of new vaccines, and to allocate scarce public and external resources available for immunisation in the most optimal manner. Policy analyses of vaccination programmes typically seek to answer the question: which immunisation programme generates the best health outcomes per dollar spent by the public-health system? These analyses help decision-makers to select programmes that maximise health benefits for a given level of costs.  At the same time, it is important to compare the total cost and benefits of a vaccination program in light of whether a vaccination program increases the general welfare of the society. This argument necessitates measuring the benefits of the program in monetary terms. The willingness-to-pay approach is widely used to value the health benefits of healthcare intervention that engaged this research project. 

Aim of the project

The overarching aim of this project is to investigate the health and economic burden of diarrheal diseases in Bangladesh and to generate some evidence for health policy makers about future nationwide cholera and rotavirus vaccination programs which have hitherto been inadequately studied.