Prescott N, Prost A, Le Berre R
Soc Sci Med. 1984;19(10):1051-5. doi: 10.1016/0277-9536(84)90307-1.
This paper proposes a new approach to the economics of blindness prevention under the Onchocerciasis Control Program in Upper Volta. It differs from previous economic analyses of onchocerciasis control in three important respects. First, it uses empirical data as the basis of an estimate of the epidemiological effectiveness of the intervention. Second, it focuses on the prevention of permanent disability and premature death due to onchocercal blindness as the major health improvement attributable to onchocerciasis control. Third, it emphasizes cost-effectiveness rather than cost-benefit analysis. This limitation is imposed by the difficulty of undertaking a comprehensive assessment of the benefits of onchocerciasis control. In particular, the extent to which control of partial visual impairment and infection without ocular involvement would increase the effective supply of labor, and also the extent to which control would increase the effective supply of land by inducing new settlement in the river valleys, have not been clearly established. The cost-effectiveness approach is limited because it foregoes the opportunity provided by cost-benefit analysis to compare the relative desirability of investing in onchocerciasis control with alternative investments in other sectors. However, it does permit useful judgments to be made about the relative efficiency of allocating scarce resources to onchocerciasis control compared to other possible investments within the health sector. For this purpose, an illustrative comparison is made with estimates of the cost-effectiveness of measles immunization.
本文提出了一种针对上沃尔特盘尾丝虫病控制项目下失明预防经济学的新方法。它在三个重要方面与之前对盘尾丝虫病控制的经济分析有所不同。首先，它将实证数据用作干预措施流行病学有效性估计的基础。其次，它将预防盘尾丝虫病性失明导致的永久性残疾和过早死亡作为盘尾丝虫病控制带来的主要健康改善。第三，它强调成本效益而非成本效益分析。这种限制是由于对盘尾丝虫病控制效益进行全面评估存在困难而施加的。特别是，控制部分视力损害和无眼部受累的感染在多大程度上会增加劳动力的有效供给，以及控制在多大程度上会通过促使在河谷地区形成新的定居点来增加土地的有效供给，尚未明确确定。成本效益方法存在局限性，因为它放弃了成本效益分析提供的将投资于盘尾丝虫病控制与其他部门的替代投资的相对可取性进行比较的机会。然而，与在卫生部门内的其他可能投资相比，它确实允许就将稀缺资源分配给盘尾丝虫病控制的相对效率做出有用的判断。为此，与麻疹免疫接种的成本效益估计进行了说明性比较。
