Three Papers in International Health Policy: Modeling the Links between Economics and Epidemiology
Abstract
Paper I establishes the benefits of linking epidemiological modeling with international health resource allocation decisions, reviewing the recent modeling literature on pandemic influenza control. The review indicates that outbreaks in resource poor settings are controllable with moderate resource intensity and complexity of effort for viral strains of moderate infectiousness. However, very high resource allocations for preparedness in industrialized nations -- at low geographic risk for the pandemic -- are predicated on containment failure in countries at higher risk of outbreaks. Without assuming the infectiousness of a future flu virus, a redistribution of resources to the developing countries at primary risk reduces overall systemic risk of containment failure. The payoffs in terms of reduced global mortality and morbidity are higher with increased infectiousness. The two other papers are associated with implementing the experimental desktop models for the context of India. Paper II first constructs a scenario based a nonepidemiological model of pandemic influenza introduction to, and subsequent spread within, India under various assumptions. The model uses published data on attack rates in Asia during previous pandemics as well as seasonal influenza. The model exploits geographical risk variations across provinces of India as well as the provinces' demographics, transport networks, and rural urban settings. Paper III reestimates the estimates of people living with HIV/AIDS (PLWHA) in India by combining the available prevalence data from the latest sero-surveillance data as well as the National Family Health Survey (NFHS-3) of 2005-2006. The paper continues to comprehensively analyze antiretroviral (ARV) policy in India, beginning with the estimation of total costs of utilization under public and private market rates for first line ART. A cohort simulation is conducted using a desktop model of disease progress in the population without access to ARVs.
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 01, 2008
- Accession Number
- ADA487787
Entities
People
- Arindam Dutta
Organizations
- RAND Corporation