Kid Risk, Columbus, Ohio, USA.
Global Polio Eradication Initiative, World Health Organization, Geneva, Switzerland.
BMJ Open. 2019 Jan 21;9(1):e023290. doi: 10.1136/bmjopen-2018-023290.
To characterise the costs, including for environmental surveillance (ES), of the Global Polio Laboratory Network (GPLN) that provides laboratory support to the Global Polio Eradication Initiative (GPEI).
We conducted a survey of the network across 92 countries of the 146 GPLN laboratories plus three non-GPLN laboratories that concentrate environmental samples to collect information about their activities, characteristics and costs during 2016. We estimate the total costs using regression of reported responses and complementing the findings with GPEI data.
We received responses from 132 (89%) of the 149 laboratories, with variable response rates for individual questions. We estimate that processing samples of patients with acute flaccid paralysis leads to total costs of approximately $28 million per year (2016 US$) based on extrapolation from reported costs of $16 million, of which 61% were supported by internal (national) funds. Fifty-nine (45%) of the 132 responding laboratories reported supporting ES and we estimate an additional $5.3 million of recurring costs for ES activities performed by the laboratories. The reported costs do not include an estimated additional $10 million of annual global and regional costs to coordinate and support the GPLN. On average, the staff supported by funding for polio in the responding laboratories spent 30% of their time on non-polio activities. We estimate total costs for laboratory support of approximately $43 million (note that this estimate does not include any field or other non-laboratory costs of polio surveillance).
Although countries contribute significantly to the GPLN financing, many laboratories currently depend on GPEI funds, and these laboratories also support the laboratory component of surveillance activities for other diseases. Sustaining critical global surveillance for polioviruses and transitioning support for other disease programmes will require continued significant funding after polio certification.
描述全球脊髓灰质炎实验室网络（GPLN）的成本，包括环境监测（ES）成本，该网络为全球消灭脊灰行动（GPEI）提供实验室支持。
我们对全球 146 个 GPLN 实验室中的 92 个国家以及 3 个集中收集环境样本的非 GPLN 实验室进行了网络调查，以收集 2016 年期间它们的活动、特征和成本信息。我们使用报告回复的回归来估计总成本，并使用 GPEI 数据补充调查结果。
我们收到了来自 149 个实验室中的 132 个（89%）的回复，个别问题的回复率存在差异。我们根据报告的 1600 万美元成本的推断，估计处理急性弛缓性麻痹患者样本每年导致约 2800 万美元的总成本（2016 年美元），其中 61%由内部（国家）资金支持。132 个有回复的实验室中有 59 个（45%）报告支持 ES，我们估计实验室进行的 ES 活动每年还需要额外的 530 万美元的经常性成本。报告的成本不包括估计的每年全球和区域协调和支持 GPLN 的额外 1000 万美元费用。在有回复的实验室中，由脊灰资金支持的工作人员平均将 30%的时间用于非脊灰活动。我们估计实验室支持脊灰的总成本约为 4300 万美元（请注意，此估计不包括脊灰监测的任何现场或其他非实验室费用）。
尽管各国对 GPLN 融资做出了重大贡献，但许多实验室目前依赖 GPEI 资金，这些实验室还支持其他疾病的实验室监测活动的实验室部分。在脊灰认证后，为了维持对脊灰病毒的关键全球监测并为其他疾病规划过渡支持，仍需要持续提供大量资金。
