The Indirect cost of illness in Africa

  • Joses Muthuri Kirigia Directorate of Research & School of Health Sciences, Meru University of Science and Technology, Meru, Kenya
  • Germano Mwiga Mwabu School of Economics, University of Nairobi, Nairobi, Kenya

Abstract

Background: The current study estimated (a) the indirect costs associated with non-fatal disability and premature death across a wide range of diseases and health conditions in Africa in 2015 and (b) the potential savings that could be accrued if countries were to meet the 3 health targets of the substainable development goal (SDG) compared to the costs under the status quo.


Methods: This study used the lost output or human capital approach to quantify the gross domestic product (GDP) losses associated with the disability-adjusted-life-years (DALYs) lost due to all causes by age group as well as by country economic classification (Group 1: 10 high/upper-middle income countries; Group 2: 17 lower-middle income countries; and Group 3: 27 low income countries).


Results: The expected indirect cost of the 704,765,879 DALYs lost in Africa in 2015 was Int$ 2,983,187,560,197. Of this amount, 25.17%, 57.84% and 16.99% were incurred by the economies of the countries comprising Group 1, Group 2 and Group 3, respectively. Of the total continental indirect cost, 36.9%, 10.5%, 13.7%, 17.0%, 7.6%, 6.8% and 7.5% were associated with people aged 0-4, 5-14, 15-29, 30-49, 50-59, 60-69 and 70 years or older, respectively. Most of the total indirect cost (56.61%) was attributable to maternal conditions, AIDS, tuberculosis (TB), malaria, neglected tropicald diseases (NTDs), non-communicable diseases and traffic injuries. Approximately half (47%) of this cost could be avoided (or saved) every year if the 3 (health) targets of the SDG were fully met.


Conclusion: The study estimated the total indirect cost of illness due to all causes by age group and country economic classification. The annual indirect cost is substantial. The findings contained in this paper suggest that health system strengthening should focus on both rich and poor countries, people of all ages and specific disease categories.


 

Author Biography

Joses Muthuri Kirigia, Directorate of Research & School of Health Sciences, Meru University of Science and Technology, Meru, Kenya

Directorate of Research & School of Health Sciences, Meru University of Science and Technology, Meru, Kenya

References

1. World Health Organization (WHO). Global Health Estimates 2015: DALYs by Cause, Age, Sex, by Country and by Region, 2000-2015. Geneva: WHO; 2016.
2. WHO. WHO methods and data sources for global burden of disease 2000-2015. Global Health Estimates Technical Paper WHO/HIS/HSI/GHE/2017.1. Geneva: World Health Organization; 2017.
3. United Nations (UN). Seventieth session of the United Nations General Assembly resolution A/RES/70/1. Transforming our world: the 2030 Agenda for Sustainable Development. New York: UN; 2015.
4. United Nations. Concept Note. High Level Meeting «Way forward to enhancing Innovative Financing for 2030 Sustainable Development Goals: recommendations from 2015 Tbilisi Solidarity and Innovative Financing Forum» on the margins of the 71st Session of the United Nations General Assembly. New York: UN; 2016.
5. WHO. Final report of the Commission for Macroeconomics and Health. Geneva: WHO; 2001.
6. Kirigia JM, Sambo LG. Cost of mental and behavioural disorders in Kenya. Annals of General Hospital Psychiatry. 2003; 2(7). Available from: http://www.annals-general-psychiatry.com/content/pdf/1475-2832-2-7.pdf
7. Kirigia JM, Sambo LG, Aldis W, Mwabu G. Impact of disaster-related mortality on gross domestic product in the WHO African Region. BMC Emergency Medicine. 2004; 4(1). Available from: http://www.biomedcentral.com/1471-227X/4/1
8. Kirigia JM, Oluwole D, Gatwiri D, Kainyu LH. Effects of maternal mortality on gross domestic product (GDP) in the WHO African Region. African Journal of Health Sciences. 2006; 13(1-2): 86-95.
9. Kirigia JM, Mwabu GM, Orem JN, Muthuri RDK. Indirect cost of maternal deaths in the WHO African Region in 2010. BMC Pregnancy and Childbirth. 2014; 14(299). Available from: http://www.biomedcentral.com/1471-2393/14/299
10. Kirigia JM, Mwabu GM, Orem JN, Muthuri RDK. Indirect cost of maternal deaths in the WHO African Region, 2013. International Journal of Social Economics. 2016; 43(5): 532 - 548.
11. Kirigia JM, Sambo HB, Sambo LG, Barry SP. Economic burden of diabetes mellitus in the WHO African region. BMC International Health and Human Rights. 2009; 9(6). Available from: http://www.biomedcentral.com/1472-698X/9/6
12. Kirigia JM, Sambo LG, Yokouide A, Soumbey-Alley E, Muthuri LK, Kirigia DG. Economic burden of cholera in the WHO African region. BMC International Health and Human Rights. 2009; 9(8). Available from: http://www.biomedcentral.com/1472-698X/9/8
13. Orem JN, Kirigia JM, Azairwe R, Kasirye I, Walker O. Impact of malaria morbidity on gross domestic product in Uganda. International Archives of Medicine. 2012; 5(12). Available from: http://www.intarchmed.com/content/5/1/12
14. Gallup JL, Sachs JD. The economic burden of malaria. Am J Trop Med Hyg. 2001; 64(1-2 suppl):85–96.
15. Nonvignon J, Aryeetey GC, Malm KL, Agyemang SA, Aubyn VNA, Peprah NY, Bart-Plange CN, Aikins M. Economic burden of malaria on businesses in Ghana: a case for private sector investment in malaria control. Malaria Journal. 2016; 15(454). Available from: https://malariajournal.biomedcentral.com/articles/10.1186/s12936-016-1506-0
16. Kirigia JM, Muthuri RDK, Nabyonga-Orem J, Kirigia DW. Counting the cost of child mortality in the World Health Organization African region. BMC Public Health. 2015; 15(1103). Available from: http://www.biomedcentral.com/content/pdf/s12889-015-2465-z.pdf
17. Kirigia JM, Masiye F, Kirigia DW, Akweongo P. Indirect costs associated with deaths from the Ebola virus disease in West Africa. Infectious Diseases of Poverty. 2015; 4(45). Available from: http://www.idpjournal.com/content/4/1/45
18. Kirigia JM, Muthuri RDK. Productivity losses associated with tuberculosis deaths in the World Health Organization African Region. Infectious Diseases of Poverty. 2016; 5(43). Available from: https://idpjournal.biomedcentral.com/articles/10.1186/s40249-016-0138-5
19. Kirigia JM, Mwabu GM, M’Imunya JM, Muthuri RDK, Nkanata LHK, Bundi GE. Indirect cost of non-communicable diseases deaths in the World Health Organization African Region. International Archives of Medicine. 2017; 10(34): 1-21. Available at: http://imedicalsociety.org/ojs/index.php/iam/article/view/2400
20. Petty W. Political Arithmetick, or a Discourse: Concerning, the Extent and Value of Lands, People, Buildings; Husbandry, Manufacture, Commerce, Fishery, Artizans, Seamen, Soldiers; Publick Revenues, Interest, Taxes, Superlucration, Registries, Banks. London: Robert Caluel; 1699.
21. Fein R. Economics of mental illness. New York: Basic Books; 1958.
22. Mushkin SJ, Collings FA. Economic costs of disease and injury. Public Health Reports. 1959; 74(9): 795-809.
23. Weisbrod BA. Costs and benefits of medical research: a case study of poliomyelitis. Journal of Political Economy. 1971; 79(3): 527-544.
24. Landefeld JS, Seskin EP. The economic value of life: linking theory to practice. American Journal of Public Health. 1982; 72(6): 555-566.
25. World Health Organization Regional Office for Africa (WHO/AFRO). HIV/AIDS: Strategy for the African Region (Document AFR/RC62/10). Sixty-second session of Regional Committee for Africa resolution AFR/RC62/R2. Brazzaville: WHO/AFRO; 2012.
26. WHO. Global technical strategy for malaria 2016-2030. Geneva: WHO; 2015.
27. WHO. The end TB strategy. Geneva: WHO; 2015.
28. WHO. Draft global vector control response at a glance. Geneva: WHO; 2016.
29. International Monetary Fund (IMF). World Economic Outlook Database. Washington, D.C.: IMF; 2016. Available from: http://www.imf.org/external/pubs/ft/weo/2015/02/weodata/weorept.aspx? Accessed on 7 February 2017 at 15h30.
30. WHO. Global Health Expenditure Database. Geneva: WHO; 2017. Available from: http://apps.who.int/nha/database/ViewData/Indicators/en. Accessed on 7 Feb 2017 at 11h26
31. WHO. World Health Statistics 2016. Geneva: WHO; 2016.
32. World Bank. World Bank Country and Lending Groups - Country Classification. Washington, D.C.: World Bank; 2016. Available from: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups Accessed: 11AM 30 November 2016.
33. WHO. The global strategy for women’s, children’s and adolescents’ health (2016–2030). Document: Document A69/16. Sixty-Ninth World Health Assembly resolution WHA69.2. Geneva: WHO; 2016.
34. WHO/AFRO. Addressing the challenge of women’s health in Africa: report of the commission on women’s health in the African region (Document AFR/RC63/8). Sixty-third session of Regional Committee for Africa resolution AFR/RC63/R4. Brazzaville: WHO/AFRO; 2013.
35. United Nations. Every Woman Every Child. UN Commission on life-saving commodities for women and children: commissioners’ report September 2012. New York: United Nations; 2012.
36. WHO. Global health sector strategy on HIV 2016–2021: towards ending AIDS. The Sixty-ninth World Health Assembly Resolution. Document: A69/31. Geneva: WHO; 2016.
37. WHO. Draft global health sector strategy on sexually transmitted infections, 2016–2021. WHA document A69/33. Geneva: WHO; 2016.
38. WHO. Draft global health sector strategy on viral hepatitis, 2016–2021 – the first of its kind. WHA document A69/32. Geneva: WHO; 2016.
39. WHO. Global Plan to Combat Neglected Tropical Diseases 2008–2015. Geneva: WHO; 2007.
40. WHO. Accelerating work to overcome the global impact of neglected tropical diseases: a roadmap for implementation. Document: WHO/HTM/NTD/2012.1. Geneva: WHO; 2012.
41. WHO. Neglected tropical diseases. Sixty-sixth World Health Assembly resolution WHA66.12. Geneva: WHO; 2013.
42. WHO. Global vector control response 2017–2030. 140th session of Executive Board – 5 December 2016. Document: EB140/26. Geneva: WHO;2016.
43. WHO/AFRO. Regional strategy on neglected tropical diseases in the WHO African region. Document AFR/RC63/10. Adopted by Sixty-third session of Regional Committee for Africa resolution AFR/RC63/R6. Brazzaville: WHO/AFRO; 2013.
44. WHO/AFRO. Regional Strategic Plan for Neglected Tropical Diseases in the African Region 2014–2020. Brazzaville: WHO/AFRO; 2013.
45. WHO. Global strategy for the prevention and control of noncommunicable diseases. WHA Resolution WHA 53.14. Geneva: WHO;2000.
46. WHO. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. The Sixty-sixth World Health Assembly resolution WHA66.10. Geneva: WHO; 2013.
47. WHO. Global strategy on diet, physical activity and health. Fifty-seventh WHA resolution A57/9. Geneva: WHO; 2004.
48. WHO. Oral health: action plan for promotion and integrated disease prevention. WHA resolution WHA60.17. Geneva: WHO; 2007.
49. WHO. WHO Framework Convention on Tobacco Control. Fifty-Sixth World Health Assembly WHA56.1 WHA56.1 Geneva: WHO; 2003.
50. WHO. Comprehensive mental health action plan 2013–2020. WHA resolution WHA66.8. Geneva: WHO; 2013.
51. WHO/AFRO. Health promotion: strategy for the African region (Document AFR/RC62/9). Sixty-second Regional Committee for Africa resolution AFR/RC62/R4. Brazzaville: WHO/AFRO; 2012.
52. WHO/AFRO. a strategy for addressing key determinants of health in the African region (Document AFR/RC60/3). Sixtieth Regional Committee for Africa resolution AFR/RC60/R1. Brazzaville: WHO/AFRO; 2010.
53. UN. Prevention and control of non-communicable diseases. UNGA resolution A/RES/64/265. New York: UN; 2010.
54. WHO. Global Plan for the Decade of Action for Road Safety 2011–2020. Geneva: WHO; 2010.
55. WHO. Addressing the challenges of the United Nations Decade of Action for Road Safety (2011–2020): outcome of the second Global High-level Conference on Road Safety – Time for Results. Sixty-ninth World Health Assembly resolution WHA69.7. Geneva: WHO; 2016.
56. WHO. Road safety and health. The Fifty-seventh World Health Assembly resolution WHA57.10. Geneva: WHO; 2004.
57. UN. Improving global road safety. UN General Assembly resolution A/RES/64/255. New York: UN; 2010.
58. Brasilia Declaration. Second Global High-level Conference on Road Safety: Time for Results Brasilia, 18-19 November 2015.
59. WHO. WHO global strategy on people-centred and integrated health services. Document WHO/HIS/SDS/2015.6. Geneva: WHO; 2015.
60. WHO. Global Strategy on Human Resources for Health: Workforce 2030. Geneva: WHO; 2015.
61. WHO/AFRO. Road map for scaling up the human resources for health for improved health service delivery in the African region 2012–2025 (Document AFR/RC62/7). Sixty-second Regional Committee for Africa resolution AFR/RC62/R3. Brazzaville: WHO/AFRO; 2012.
62. WHO. WHO global strategy on people-centred and integrated health services. Document WHO/HIS/SDS/2015.6. Geneva: WHO; 2015.
63. WHO. Global Strategy on Human Resources for Health: Workforce 2030. Geneva: WHO; 2015.
64. WHO/AFRO. Road map for scaling up the human resources for health for improved health service delivery in the African region 2012–2025 (Document AFR/RC62/7). Sixty-second Regional Committee for Africa resolution AFR/RC62/R3. Brazzaville: WHO/AFRO; 2012.
65. Bloom DE, Canning D. The Health and Wealth of Nations. Science. 2000; 287(5456):1207–1209.
66. Bloom DE, Canning D. The Health and Wealth of Africa. World Economics. 2004; 5(2): 57-81.
Published
2018-06-01
How to Cite
KIRIGIA, Joses Muthuri; MWABU, Germano Mwiga. The Indirect cost of illness in Africa. International Archives of Medicine, [S.l.], v. 11, june 2018. ISSN 1755-7682. Available at: <http://imedicalsociety.org/ojs/index.php/iam/article/view/2817>. Date accessed: 20 june 2018. doi: https://doi.org/10.3823/2568.
Section
Global Health & Health Policy