title: The Estimated Health and Economic Benefits of Three Decades of Polio Elimination Efforts in India.
abstract: OBJECTIVE
  In March 2014, India, the country with historically the highest burden of polio, was declared polio free, with no reported cases since January 2011. We estimate the health and economic benefits of polio elimination in India with the oral polio vaccine (OPV) during 1982-2012.
  
  
  METHODS
  Based on a pre-vaccine incidence rate, we estimate the counterfactual burden of polio in the hypothetical absence of the national polio elimination program in India. We attribute differences in outcomes between the actual (adjusted for under-reporting) and hypothetical counterfactual scenarios in our model to the national polio program. We measure health benefits as averted polio incidence, deaths, and disability adjusted life years (DALYs). We consider two methods to measure economic benefits: the value of statistical life approach, and equating one DALY to the Gross National Income (GNI) per capita.
  
  
  RESULTS
  We estimate that the National Program against Polio averted 3.94 million (95% confidence interval [CI]: 3.89-3.99 million) paralytic polio cases, 393,918 polio deaths (95% CI: 388,897- 398,939), and 1.48 billion DALYs (95% CI: 1.46-1.50 billion). We also estimate that the program contributed to a $1.71 trillion (INR 76.91 trillion) gain (95% CI: $1.69-$1.73 trillion [INR 75.93-77.89 trillion]) in economic productivity between 1982 and 2012 in our base case analysis. Using the GNI and DALY method, the economic gain from the program is estimated to be $1.11 trillion (INR 50.13 trillion) (95% CI: $1.10-$1.13 trillion [INR 49.50-50.76 trillion]) over the same period.
  
  
  CONCLUSIONS
  India accrued large health and economic benefits from investing in polio elimination efforts. Other programs to control/eliminate more vaccine-preventable diseases are likely to contribute to large health and economic benefits in India.
authors: Center for Disease Dynamics, Economics and Policy, Washington, USA; *School of Public Health, Chandigarh, India; and #Retired Professor of Clinical Virology, Christian Medical College, Vellore, TN, India. Correspondence to: Dr Arindam Nandi, The Center for Disease Dynamics, Economics and Policy, Washington, USA. nandi@cddep.org.
authors: Arindam
authors: A
authors: Nandi
authors: Devra M
authors: DM
authors: Barter
authors: Shankar
authors: S
authors: Prinja
authors: T Jacob
authors: TJ
authors: John
mesh_terms: D002648:Child; D060740:Disease Eradication / Q000706:statistics & numerical data*; D006801:Humans; D007194:India; D007223:Infant; D011051:Poliomyelitis / Q000191:economics / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D019057:Quality-Adjusted Life Years