The Economics of One Health: Extraordinarily High Returns on Investments in One Health Approaches

Economics of One Health Presentation to the One Health Summit 2012 Davos, February 19-23, 2012 Olga Jonas, Economic Adviser, World BankReport by Jimmy Smith, Cornelis de Haan and Sarah Stephenson

OUTLINE• Impact on livestock, people, economies• How can One Health approaches help reduce these costs? – Effectiveness gains – Efficiency gains (within increased investments and recurrent expenditures, esp. in developing countries)• Return on investment in One Health systems 2

Zoonotic diseases account for half oflivestock losses due to diseases Non-zoonoses 50% 50% Zoonoses Total loss: Source: SAFOSO 762‘212 LSUs 3

IMPACT ON HUMANS - SELECT ZOONOTIC DISEASES DISEASE PERIOD Reported Reported cases fatalities SARS 2002-3 7,918 761 HPAI 2004-present 584 345 West Nile 1999-2008 28,975 1,124 Rift Valley 2006-7 1,062 315 Fever HIV/AIDS 2009 2.6 m/year 1.8 m/year (25m since 1981) Flu Pandemic of 1918/19: 50 million to 100 million died

What is the burden (total cost) of diseasesand what are its components?• Only partial information, but better data are increasingly needed (and will become even more necessary)• To assess total cost, useful to look at components of costs of outbreaks in animals and in humans• Costs of selected major outbreaks in 1986-2009 5

Components of economic costs due to zoonotic disease outbreaks100%90% Spill-over effects in other Indirect impact80% sectors (tourism, transport,70% retail, etc) Avoidance behaviors60%50% Ripple effects:40% -- Reduced demand -- Complementary products Consequential on-farm losses -30% Illness and absenteeism Direct impact Lower Productivity20% Deaths from disease10% & control measures Mortality Control measures Medical costs 0% Outbreak in animals Outbreak in humans 6

Costs of selected zoonotic disease outbreaks SARS (Asia, Canada, rest 50 of the world), 2002 45 40 35 30US $ billion HPAI (Asia), 2004 25 BSE (UK), 1986 20 15 BSE (USA), 2004 10 Plague (India), Nipah virus 5 1994 (Malaysia), 1998 HPAI (Europe), 2005 RVF WNV, 1999 (Kenya, Somalia, Tanzani 0 a), 2006 1980 1985 1990 1995 2000 2005 2010 7

“Indirect” economic costs: Tourist arrivalsin China and Thailand 8

Adding it up: costs of zoonotic diseases (select outbreaks, US$ billion) Costs (conservative Annual Period estimates) average6 outbreaks other than SARS-Nipah virus (Malaysia),-West Nile fever (USA),-HPAI (Asia, Europe), 1998-2009 38.7-BSE (US),-Rift Valley Fever (Tanzania, Kenya, Somalia)- BSE (UK) costs in 1997-09 onlySARS 2002-2004 41.5Total in 12 year 80.2period (1998-2009) 6.7 9

Poor households hardest hit – householdincome effect of backyard poultry sales ban

• Significant negative impacts …. (but only partially monitored and documented)• What could One Health approaches contribute to reduce negative impacts? 11

One Health approach – an integratedresponse to “what needs to be done?” -- as opposed to the classical approachbased on “what can I do?” 12

One Health approaches can increase: • EFFECTIVENESS – doing the right thing, getting the desired results: prevention, accurate and timely diagnostics, effective control measures • EFFICIENCY – doing the thing right, achieving results at least cost 13

Delays increase costs Cost of Exposure control Exposure in humans Clinical outbreak Clinical in animals signs in signs in animals humans Humans seek medical care Adapted from IOM (2009) 14

Funding requirements for “One Health” efficient prevention and control system• Total for 139 low- and middle-income countries –$ 1.9 b – 3.4 b per year » Note: actual losses in 1998-2008 were >US$ 6.7b/year (i.e., double) – About 7x more than current effort, which is waning due to “flu fatigue” – Equivalent to $1.90 - $3.40 per person per year in OECD countries (the price of greater health security and protection of incomes) 15

Annual costs of prevention vs Annual expected benefits of 40 prevention of pandemic and non- 35 pandemic outbreaks 6.7b 30 25$ billion per year 20 6.7 b 15 10 5 0 Costs of prevention Benefits from averted Benefits from averted (investments in animal mild pandemic severe pandemic and human health systems) 16

Case 1 : Mild Influenza Pandemic* Annual Expected Rate of Return on Investments in Prevention high low preventive preventive effort effort 20% 31% 14% Reduction in expected disease 50% 65% 44% outbreak impact 100% 97% 71%* Impact $600 b (1% of GDP), probability 2.5%, expected benefit of prevention $15 b/year 17

Case 2: Severe Influenza Pandemic Annual Expected Rate of Return on Investments in Prevention low preventive high preventive effort effort 20% 49% 25% Reduction in expected disease 50% 88% 57% outbreak impact 100% 123% 86%* Impact $3 trillion (4.8% of GDP), probability 1%, expected benefit of prevention $30 b/year 18

Avian & Pandemic Influenzas - Donor Interest Has Vanished 2,000 36 35 1,800 32 Number of donors pledging 1,600 28 1,400 Loans 24 1,200$ million 20 1,000 17 16 800 12 600 9 8 400 Grants 8 200 4 4 0 0 Beijing Bamako Delhi Sharm El - After SES, (Jan 06) (Dec 06) (Dec 07) Sheikh 2009 (Oct 08) Financing gap Pledges Number of donors pledging 19

Characteristics of financing for One Health systems• Constant over time, medium- to long-term, and reliably assured (not emergency response financing)• Reach countries with greatest gaps in veterinary and human health systems• Should be on grant basis (global public good) … and also include contribution from sector/livestock product consumers• Encourage prompt and complete reporting of outbreaks at national, regional and international levels 20

Some options for mobilizing resources for One Health systems• Official Development Assistance -- insufficient and unreliable, prevention typically not a priority.• World Bank, AsDB, AfDB etc – time-bound loans (good in emergencies, as last resort). Could “blend” with grants for leverage.• Dedicated funding from donors (with fair burdensharing) plus a levy on livestock products and/or contributions from consumers wishing to lower their pandemic risk. Governance of fund could include livestock producer associations, official and scientific representatives, civil society.• Private sector – international and domestic 21

Value Added of One Health Approaches1. support poverty alleviation and economic growth in developing countries2. reduce pandemic risk globally3. improve public health globally4. help build effective animal and human health systems without weak links; “effective” means early detection and rapid response; delays result in less effective disease control and higher risks at the animal-human- environment interface5. help build efficient animal and human health systems; “efficient” because of shared capacities and information, reduction of duplication, economies of scope, economies of scale6. Net expected annual benefit between $3.8 billion (no pandemics) and $33.8 billion (1 pandemic/100 years) 22

Thank you.www.worldbank.org/flu 23

http://grforum.org	89
http://www.grforum.org	70
http://onehealth.grforum.org	35
http://www.idrc.info	9
http://onehealth.testing.grforum.net	3
http://idrc.info	1

The Economics of One Health: Extraordinarily High Returns on Investments in One Health Approaches

by Global Risk Forum GRFDavos

Accessibility

Categories

Upload Details

Usage Rights

6 Embeds 207

Statistics

The Economics of One Health: Extraordinarily High Returns on Investments in One Health Approaches Presentation Transcript