title: National mass drug administration costs for lymphatic filariasis elimination.
abstract: BACKGROUND
  Because lymphatic filariasis (LF) elimination efforts are hampered by a dearth of economic information about the cost of mass drug administration (MDA) programs (using either albendazole with diethylcarbamazine [DEC] or albendazole with ivermectin), a multicenter study was undertaken to determine the costs of MDA programs to interrupt transmission of infection with LF. Such results are particularly important because LF programs have the necessary diagnostic and treatment tools to eliminate the disease as a public health problem globally, and already by 2006, the Global Programme to Eliminate LF had initiated treatment programs covering over 400 million of the 1.3 billion people at risk.
  
  
  RESULTS
  To obtain annual costs to carry out the MDA strategy, researchers from seven countries developed and followed a common cost analysis protocol designed to estimate 1) the total annual cost of the LF program, 2) the average cost per person treated, and 3) the relative contributions of the endemic countries and the external partners. Costs per person treated ranged from $0.06 to $2.23. Principal reasons for the variation were 1) the age (newness) of the MDA program, 2) the use of volunteers, and 3) the size of the population treated. Substantial contributions by governments were documented - generally 60%-90% of program operation costs, excluding costs of donated medications.
  
  
  CONCLUSIONS
  MDA for LF elimination is comparatively inexpensive in relation to most other public health programs. Governments and communities make the predominant financial contributions to actual MDA implementation, not counting the cost of the drugs themselves. The results highlight the impact of the use of volunteers on program costs and provide specific cost data for 7 different countries that can be used as a basis both for modifying current programs and for developing new ones.
authors.affiliation: Department of Epidemiology, The George Washington School of Public Health and Health Services, Washington, DC, United States of America. sphasg@gwumc.edu
authors.forename: Ann S
authors.initials: AS
authors.lastname: Goldman
authors.forename: Victoria H
authors.initials: VH
authors.lastname: Guisinger
authors.forename: Moses
authors.initials: M
authors.lastname: Aikins
authors.forename: Maria Lourdes E
authors.initials: ML
authors.lastname: Amarillo
authors.forename: Vicente Y
authors.initials: VY
authors.lastname: Belizario
authors.forename: Bertha
authors.initials: B
authors.lastname: Garshong
authors.forename: John
authors.initials: J
authors.lastname: Gyapong
authors.forename: Conrad
authors.initials: C
authors.lastname: Kabali
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Kamal
authors.forename: Sanjat
authors.initials: S
authors.lastname: Kanjilal
authors.forename: Dominique
authors.initials: D
authors.lastname: Kyelem
authors.forename: Jefrey
authors.initials: J
authors.lastname: Lizardo
authors.forename: Mwele
authors.initials: M
authors.lastname: Malecela
authors.forename: Godfrey
authors.initials: G
authors.lastname: Mubyazi
authors.forename: P Abdoulaye
authors.initials: PA
authors.lastname: Nitièma
authors.forename: Reda M R
authors.initials: RM
authors.lastname: Ramzy
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Streit
authors.forename: Aaron
authors.initials: A
authors.lastname: Wallace
authors.forename: Molly A
authors.initials: MA
authors.lastname: Brady
authors.forename: Richard
authors.initials: R
authors.lastname: Rheingans
authors.forename: Eric A
authors.initials: EA
authors.lastname: Ottesen
authors.forename: Anne C
authors.initials: AC
authors.lastname: Haddix
mesh_terms: D015766:Albendazole / Q000191:economics / Q000627:therapeutic use; D000871:Anthelmintics / Q000191:economics / Q000627:therapeutic use*; D002050:Burkina Faso / Q000453:epidemiology; D003365:Costs and Cost Analysis; D004049:Diethylcarbamazine / Q000191:economics / Q000627:therapeutic use; D004293:Dominican Republic / Q000453:epidemiology; D004358:Drug Therapy / Q000191:economics / Q000379:methods; D004534:Egypt / Q000453:epidemiology; D004604:Elephantiasis / Q000188:drug therapy / Q000517:prevention & control; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000517:prevention & control; D005869:Ghana / Q000453:epidemiology; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D010348:Patient Care Team; D010679:Philippines / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000871:Anthelmintics; D015766:Albendazole; D004049:Diethylcarbamazine