New threats to the public health

Unfortunately, the gains achieved by immunization programs may be offset by losses from infectious diseases that are not vaccine-preventable and non-infectious

Table 10.1 Direct and indirect savings from vaccination

Comparative savings

Direct or indirect savings (US$)





Measlese One case of measles is 23

times the cost of vaccinating one child against measlesb Cholera NA

Malaria NA

MMRg For every US$1 spent on MMR vaccine, more than US$21 is saved in direct medical care costs DTaPg For every US$1 spent on DTaP vaccine, more than US$24 is saved Hibg For every US$1 spent on

Hib vaccine, more than US$2 is saved Other public health problems Plague NA AIDS NA Drug NA resistance

300 million in direct costs per year 13.6 billion in total savings worldwide by 2040

700 million in US between 1991 and 2000d

10 per disability-adjusted life-year (DALY)

770 million lost in seafood export Peru, 1991

100 billion GDP lost annually in sub-Saharan Africa because of malariaf 100 million in direct medical costs from 1989-91 measles outbreak

23.6 billion in direct and indirect costs without DTP vaccines

5 billion in direct costs and 12 billion in indirect costs incurred in USh

1.7 billion lost tourist income and trade 14 billion annual treatment cost in the US 4 billion annual treatment cost in the US

NA, not available; MMR, measles-mumps-rubella; DTaP, diphtheria-tetanus-acellular pertussis; Hib, H. influenzae type b. a Based on eradication of smallpox in 1977

b CDC, Immunization Services Division, Health Services Research and Evaluation Branch, 1999 c Based on eradication of polio by 2005

d e Canadian Institute of Health Information, Crosscutting%20Programmes/imm96p.pdf f

g Basic principles of immunization cited in Why is Immunization Important Today? Module 1: Basic Principles of Immunization; available at (accessed 23 June 2001)

h table1

1 WHO (1999). WHO Infectious Diseases Report: Removing Obstacles to Healthy Development; available at Source: Ehreth (2003).

Botswana i= Zimbabwe

Swaziland Lesotho Namibia South Africa Zambia Kenya Malawi Djibouti Mozambique Burundi Central African Republic Cote d'Ivoire Ethiopia Rwanda Cameroon Uganda United Republic of Tanzania Burkina Faso c

10 20 30 Adult HIV prevalence (%)

Figure 10.8 Years of life lost to AIDS in 20 countries with highest adult HIV prevalence, 2000-2005. Source: World Health Organization (2005b).

diseases, or by increased costs associated with chronic illness care encountered when life expectancy is increased. How gains in one area can be overshadowed by profound losses in another is illustrated by the tragic effects of the HIV epidemic on life expectancy in sub Saharan Africa (Figure 10.8).

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