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The Impact of Immunization on Economic
Development
While immunization is first and foremost a
public health issue, its benefits also have a direct bearing
on socio-economic development. The economic benefits of immunization
programs can be measured in two different ways. First, there
is a link between health and wealth, namely, the positive
impact of higher life expectancy on a country’s economic growth.
Second, immunization has proved to be very cost-effective
compared with other health interventions and as a way to save
money - over time - for both individuals and national governments.
Improved Life Expectancy Increases Economic
Growth and Development
-
Every healthy child
who survives contributes to a country’s
increased economic productivity, not merely by virtue
of their longer lives, but also because they become better
students and more productive workers. Their good health
also frees their parents and families to fulfill their roles
in society.
- Vaccines improve
labor productivity by preventing life-long disabilities
and death. For example, cost-effective vaccines against poliomyelitis,
measles, diphtheria, tetanus and pertussis, available through
the World Health Organization (WHO) and the United Nations Children’s
Fund (UNICEF), have been estimated to prevent yearly up to 3
million deaths and 750,000 cases of blindness, mental or physical
disabilities in children.(1)
- WHO data from Latin
American and Caribbean countries indicate that growth
in gross domestic product (GDP) is statistically associated
with life expectancy. The results suggest that for every
additional year of life expectancy there will be an additional
one percent increase in GDP 15 years later.(2) Also, life expectancy
at birth alone is one of the strongest indicators of growth
in GDP.
- Education and health
are two key components of a country’s development. The economic
benefits of investing in health and education
contribute to growth and the reduction of poverty.(3)
Immunization contributes both to the health of the population
and to the ability of children to take advantage of educational
opportunities. Its preventive value also frees healthcare funds
enabling larger investments to be made in education.
- Child survival helps
slow the rate of population growth. Research has shown that
the transition from large to small families
in developing countries is preceded by a decline in childhood
mortality. Parents may not feel the need to have as many
children if they have less fear that a substantial number of
their offspring will not survive to adulthood. Slowing population
growth is important because it can contribute to a more rapid
growth in per capita standard of living.(4)
Immunization is More Cost-Effective than
Other Health Interventions, Saving Individuals and Governments
Money
-
Immunization
is one of the world’s most cost-effective health interventions.
By preventing disease, it allows countries to reduce the
amount of money spent on treatment and hospitalization costs.
It helps national governments avoid the expense of treating
major outbreaks of debilitating and crippling diseases and
the loss of productivity that accompanies these illnesses.
It also increases productivity by allowing parents to work
instead of staying home to care for sick children. Better
adult health directly affects productivity by increasing
work output and reducing absenteeism.(2)
- Immunization is
the world’s greatest health bargain. It costs just US$17
to immunize a child with the six core Expanded Programme on
Immunization (EPI) vaccines (polio, diphtheria, pertussis, measles,
tetanus and tuberculosis), including all costs of delivery.
Most immunizations cost less than US$50 dollars per healthy
life year saved. This is compared to the cost of treating a
disease such as hypertension, which is estimated in the United
States to be between US$4,340 and US$87,940 per healthy life
year saved.(5) In some settings, countries can save as much
as US$29 for every dollar spent on immunization with the six
core EPI vaccines.(3)
- The worldwide interruption of the transmission
of the wild poliovirus is targeted to be achieved by the end
of the year 2000. If no transmission of the virus subsequently
occurs and the worldwide eradication of polio is confirmed (target
date 2005), WHO estimates that the governments
of the world will save an estimated US$1.5 billion in vaccine,
treatment and rehabilitation costs every year. Of this
amount, Western European countries would save US$200 million
a year (just for vaccine and immunization related expenses),
and the savings for the United States would amount to US$230
million a year.
- The entire cost of smallpox eradication,
achieved in 1979, was US$25 million per year for 12 years, while
the cost of vaccination, quarantine and treatment in a single
year at its start was over US$300 million. Thus, there
were savings of approximately $275 million per year in direct
measurable costs.(6)
- The rationale for
investing in immunization programs in developing countries is
clear: such programs represent a wise investment in human
capital development, are low-risk investments with a proven
track record of impact, are highly cost effective, have significant
economies of scale that lead to low unit costs and can be financially
sustained by developing countries.(7)
- New vaccines have been rejected by many
governments in low-income countries because of their cost. Analysis
shows that some of these newer vaccines
could be highly cost-effective in low-income countries
where disease burdens are high. A health intervention is deemed
as cost effective if it costs less than a country’s average
per-capita gross national product (GNP) for each year of healthy
life that it buys.(8) Some examples
of cost-effective vaccines are:
- The Hepatitis
B vaccine could save up to 900,000 lives per year and
would cost between US$8 and US$11 for each year of healthy
life it buys in low-income countries with high prevalence.(9)
- A vaccine against Haemophilus
influenzae type b (Hib),
a bacterial infection which causes meningitis and pneumonia,
would cost around US$21-22 per year of healthy life saved
in most low-income African countries.(6)
SOURCES
1 World Health Organization Report on
Infectious Diseases: Removing Obstacles to Healthy Development,
1999
2 WHO World Health Report, 1999: Making a Difference
3 The World Bank website, URL: http://www.worldbank.org/html/extdr/hnp/health/ppi/p1devs.htm
4 USAID website, URL: http://www.info.usaid.gov/pop_health/cs/csinvest.htm
5 Cost-effectiveness of intensive
treatment of hypertension. Based on presentations by Donald
S. Shepard, PhD; and Dominic Hodgkin, PhD; Am J Manag Care
1998 Dec 1904; discussion S770
6 Miller 1998
7 Asian Development Bank, Sustaining
Effective Social Programs; Financing Immunization in Cambodia,
Lao PDR and Viet Nam
8 A "year of healthy life" is equivalent
to a year without the burden of disease or premature death.
The term is used to explain disease burden as measured by
the DALY or disability adjusted life year. A DALY measures
both fatal and nonfatal disease burden and is the sum of years
of life lost from premature death and years lived with a disability.
One DALY equals one lost year of healthy life.
9 Miller, McCann 2000
GAVI Secretariat, c/o UNICEF,
Palais des Nations, 1211 Geneva 10, Switzerland
Tel: 41 22 909 5019 Fax: 41 22 909 5931 Email: Gavi@unicef.org
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