Authors: de Gourville, Esther¹; Duintjer Tebbens, Radboud J.²; Sangrujee, Nalinee³; Pallansch, Mark A.⁴; Thompson, Kimberly M.

Source: Risk Analysis, Volume 26, Number 6, December 2006 , pp. 1557-1569(13)

Publisher: Wiley-Blackwell

Abstract:

Effective control and eradication of diseases requires reliable information from surveillance activities, including laboratories, which typically incur real financial costs. This article presents data from a survey we conducted to estimate the costs of the Global Polio Laboratory Network (GPLN), which currently supports aggressive global surveillance for acute flaccid paralysis (AFP) to detect circulating polioviruses. The Global Polio Eradication Initiative (GPEI) of the World Health Organization (WHO) provides resources for some of the laboratory network costs, but the total cost of the network remains relatively poorly characterized given the limited documentation of national contributions. We surveyed network laboratories to quantify AFP surveillance support costs and provide data for cost estimates of potential posteradication surveillance policies related to the laboratories. We estimate that the GPLN currently requires millions (US$ 2002) in total support annually, and that half of the support for national and regional reference laboratories comes from external donors through the WHO or bilateral agreements and half from within nations that host those laboratories. The article also presents the framework for considering the value of information from this global surveillance network and suggests that the expected value of surveillance information from the GPLN currently exceeds its costs. We also provided important insights about how the value of information may change after successful eradication of wild polioviruses.

Keywords: Laboratory network; polio eradication; survellance; value of information

Document Type: Research article

DOI: 10.1111/j.1539-6924.2006.00845.x

Affiliations: 1: World Health Organization, Department of Immunization, Vaccines and Biologicals, Geneva, Switzerland. 2: Kids Risk Project, Harvard School of Public Health, 677 Huntington Avenue, 3rd Floor, Boston, MA, USA. 3: Futures Group, One Thomas Circle, NW, Suite 200, Washington, DC, USA. 4: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Polio and Picornavirus Laboratory Branch, 1600 Clifton Rd., NE, MS G-17 Atlanta, GA, USA.

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