Shaw A P M, Rushton J, Roth F, Torgerson P R
Rev Sci Tech. 2017 Apr;36(1):147-161. doi: 10.20506/rst.36.1.2618.
Decision-makers increasingly require comprehensive economic metrics summarising and comparing the benefits and costs of controlling zoonotic diseases. The impact of disease in people is conventionally quantified in non-monetary terms, usually a disability-adjusted life year (DALY), whereas the losses due to disease in animals, particularly livestock, are quantified in monetary terms. The potential for the development of a non-monetary metric for ill health in animals, based on life years lost and disability, is discussed and rejected. Within and across animal species and livestock production systems, maximising life spans is not a consistent goal and morbidity/disabilities have very different weights and often lead to culling. By relating livestock losses to a measure of national income forgone, the recently developed alternative of converting monetary losses due to livestock illness into an animal loss equivalent (ALE) provides a viable solution. Based on this, the literature on the economics of controlling zoonoses is revisited and four options for quantifying and comparing benefits and costs are examined and illustrated using numerical examples. These are i) the simplistic grouping of all monetary elements and their comparison to DALYs averted (described as the aggregate net cost method), ii) the separable costs method, iii) the use of ALEs to convert all benefits to a non-monetary equivalent, termed the zoonotic DALY (zDALY), or iv) the use of a full monetary cost-benefit analysis, based on converting DALYs to a monetary equivalent. The strengths and weaknesses of each are discussed. For effective prioritisation and decision-making, it is vital that an analytical approach is widely adopted which yields consistent results and which supports the control of zoonoses.
决策者越来越需要全面的经济指标来总结和比较控制人畜共患病的收益和成本。通常用非货币形式来量化疾病对人类的影响，通常是伤残调整生命年（DALY），而动物尤其是牲畜因疾病造成的损失则用货币形式来量化。本文讨论并否定了基于生命年损失和残疾情况制定动物健康不良非货币指标的可能性。在动物物种内部和之间以及畜牧生产系统中，最大化寿命并非一致目标，发病率/残疾情况的权重差异很大，且往往导致扑杀。通过将牲畜损失与国民收入损失衡量指标相关联，最近开发的一种替代方法是将牲畜疾病造成的货币损失转换为动物损失当量（ALE），这提供了一个可行的解决方案。基于此，本文重新审视了人畜共患病控制经济学的文献，并研究了量化和比较收益与成本的四种选择，并通过数值示例进行说明。这些选择包括：i）将所有货币要素简单分组，并与避免的DALYs进行比较（称为总净成本法），ii）可分离成本法，iii）使用ALE将所有收益转换为非货币当量，即人畜共患病DALY（zDALY），或iv）基于将DALYs转换为货币当量进行全面的货币成本效益分析。本文讨论了每种方法的优缺点。为了有效地进行优先排序和决策，至关重要的是广泛采用一种能产生一致结果并支持人畜共患病控制的分析方法。
