Christopher T. Lee, MD, MSc, MPH, is Senior Technical Advisor-Prevent Epidemics, Resolve to Save Lives, an Initiative of Vital Strategies, New York, NY. Rebecca Katz, PhD, MPH, is Professor and Director, Center for Global Health Science and Security, Georgetown University, Washington, DC. Stephanie Eaneff, MSP, is Senior Researcher, Talus Analytics, Boulder, CO. Michael Mahar, PhD, is Public Health Advisor, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Olubunmi Ojo is with the Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.
Health Secur. 2020 Jan;18(S1):S53-S63. doi: 10.1089/hs.2019.0063.
Multiple costing tools have been developed to understand the resources required to build and sustain implementation of the International Health Regulations (IHR), including a detailed costing tool developed by WHO ("WHO Costing Tool") and 2 action-based costing tools, Georgetown University's IHR Costing Tool and CDC's Priority Actions Costing Tool (PACT). The relative performance of these tools is unknown. Nigeria costed its National Action Plan for Health Security (NAPHS) using the WHO Costing Tool. We conducted a desktop review, using the other tools to compare the cost estimates generated using different costing approaches. Technical working groups developed activity plans and estimated component costs using the WHO Costing Tool during a weeklong workshop with approximately 60 participants from various ministries, departments, and federal agencies. We retrospectively applied the IHR Costing Tool and PACT to generate rapid cost estimates required to achieve a Joint External Evaluation (JEE) score of "demonstrated capacity" (level 4). The tools generated similar activities for implementation. Cost estimates varied based on the anticipated procurement and human resources requirements and by the level of implementation (eg, health facility-level versus local government area-level procurement). The desktop IHR Costing Tool and PACT tools required approximately 2 and 8 person-hours to complete, respectively. A strategic costing approach, wherein governments select from a menu of recommended and costed actions following the JEE to develop a NAPHS, could accelerate implementation of plans. Major cost drivers, including procurement and human resources, should be prioritized based on anticipated resource availability and countries' priorities.
已经开发了多种成本核算工具来了解构建和维持实施《国际卫生条例》（IHR）所需的资源，包括世卫组织开发的详细成本核算工具（“世卫组织成本核算工具”）和 2 种基于行动的成本核算工具，即乔治城大学的 IHR 成本核算工具和疾控中心的优先行动成本核算工具（PACT）。这些工具的相对性能尚不清楚。尼日利亚使用世卫组织成本核算工具对其《国家卫生安全行动计划》（NAPHS）进行了成本核算。我们进行了一次桌面审查，使用其他工具来比较使用不同成本核算方法生成的成本估算。技术工作组在为期一周的研讨会上制定了活动计划，并使用世卫组织成本核算工具估算了各组成部分的成本，约有来自各个部委、部门和联邦机构的 60 名参与者参加。我们回顾性地应用了 IHR 成本核算工具和 PACT 来生成实现联合外部评估（JEE）“展示能力”（第 4 级）所需的快速成本估算。这些工具生成了用于实施的类似活动。成本估算因预期的采购和人力资源要求以及实施水平（例如，卫生设施层面与地方政府层面的采购）而异。桌面 IHR 成本核算工具和 PACT 工具分别需要大约 2 个和 8 个人小时才能完成。政府可以从 JEE 后推荐和定价的行动菜单中进行选择，采取战略性成本核算方法来制定 NAPHS，从而加速计划的实施。应根据预期资源可用性和各国的优先事项，对包括采购和人力资源在内的主要成本驱动因素进行优先排序。
