Jonathan Rushton* , Nick Lyons, João Afonso, Alana Bouton *Professor of Animal Health Economics Royal Veterinary College, London, UK Costing a PPR Global Strategy
Acknowledgements • OIE – Bernard Vallat, Joseph Domenech • FAO – Juan Lubroth, Eran Raizman, Felix Njeumi • CIRAD – Renault Lancelot • Subhash Morzaria • Colleagues at RVC – especially Bryony Jones 3
Outline • What has been produced in the cost analysis • The main activities for the strategy proposed • Comparison between current activities with the proposed strategy • Key messages 4
The cost analysis 5
What is a cost analysis? • Strategy delivered by a technical team • The key activities defined • Costs of the key activities investigated • The scale of the activities defined through consultation of the strategy team • Costs indicated are predictive 6
Sequence for a cost analysis Cost Analysis Additional data • Prices • Populations • Production systems Costs Costs by Identification Timing Cost Benefit • Activity Strategy of Activities Location Analysis • Region Scale Modifications Decisions on who will pay and how 7
Small ruminant population • The small ruminant population remains constant throughout the 15 year period. • The age distribution was assumed to be 40% are youngstock below six months of age Remaining 60% are adults and are above 6 months of age 8
Richard Coker 9
Small ruminant population • The distribution of the small ruminant population by production system is based on modelling the aridity index and aligned to the FAOSTAT population data (Lancelot, 2014). • Two basic systems are identified and used: mixed crop/livestock system pastoralist/agro-pastoralist system 10
When to use discounting? • Where costs and benefits from a strategy are spread over a period of years they need to be discounted in order to compare them as present values • The discount factor used should be the best alternative use of money in the economy • For a costing analysis there is no need to discount – it provides an indication of the budget required for the strategy 12
The main activities of the strategy 13
Key activities • Regional and global level coordination • An ex-ante assessment of the PPR situation in the country • Surveillance to follow the disease and to monitor the vaccination efficacy • Vaccination to manage PPR 14
Coordination • Two levels of coordination – global and regional • Both will have technical staff to coordinate the laboratory diagnostics, epidemiology, socio-economics and disease control • The global and regional coordination is estimated to cost US$32.1 and US$129 million respectively • These costs will not vary over the programme 15
Ex ante assessment • Ex ante assessment will be used in stages 0 and 1 • They will enable a better understanding of the small ruminant sectors PPR presence – its maintenance and endemic areas • Three people - 9 person months per country independent of animal population of country size • The cost will be the same in each strategy considered and will be independent of the country size and animal population • Total costs per study US$90,000 per country 16
Ex ante assessment costs by region 10 US$ (Millions) 9 8 It is estimated that the ex ante 7 assessment costs will be US$9.99 6 5 million over the 15 year period 4 3 2 1 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Africa East Asia Middle East South Asia West Eurasia 17
Surveillance elements • Surveillance to follow the disease with the following components Active surveillance (mainly active in stage 1, combined in stages 2 and 3) including disease search and investigation, and sero-surveillance Passive (mainly passive in stage 4) • Surveillance to verify the efficacy of vaccination programmes are included in the post vaccination monitoring component 18
Surveillance activity costs by region 45 US$ (Millions) 40 35 It is estimated that the surveillance 30 costs will be US$242 million over the 25 15 year period 20 15 10 5 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Africa East Asia Middle East South Asia West Eurasia 19
Vaccination • Vaccination will be carried out in stages 2 and 3 • Vaccine will be targeted at key populations • Vaccination in the worst scenarios could last up to 8 years • In some populations two campaigns per season 20
Vaccination costs • The average cost of vaccinating one animal is calculated assuming: A vaccine cost of US$ 0.10 (vaccine and diluent) regardless the production system A cost of delivering the vaccine of US$ 0.60 USD in a mixed crop/livestock system per animal A cost of delivering the vaccine of US$ 0.40 in a pastoralist/agro-pastoralist system per animal 21
Vaccination stage 2 • 50% of the adult populations to be targeted for vaccination in year 1 and again in year 2. • Either one or two annual campaigns will take place in mixed crop/livestock zones compared with one in pastoral and agro pastoral zones 22
Vaccination stage 3 • The vaccination strategy among adults will depend on the success of stage 2 measured through post- vaccination monitoring (PVM) With PPR absence 50% of non-vaccinated adults will be vaccinated for two years Where PPR absence has not been demonstrated in vaccinated areas, 100% adult coverage will be targeted. • For the cost analysis it has been assumed that: 75% of the adult population will be vaccinated 100% coverage of young stock for two successive years irrespective of the PVM results. 23
Undiscounted vaccination costs by region 1200 US$ (Millions) 1000 It is estimated that the vaccination 800 costs will be US$7.23 billion over the 600 15 year period 400 200 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Africa East Asia Middle East South Asia West Eurasia 24
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Summary of the costs 26
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The estimated costs of the strategy • Total programme costs in undiscounted US$ is between 7.6 and 9.1 billion over a 15 year period • These are costs for 99 countries • The activities support a population of 1.8 billion sheep and goats • These animals provide products for 5.4 billion people 28
Total costs per year by region 1200 US$ (Millions) 1000 800 600 400 200 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 29 Africa East Asia Middle East South Asia West Eurasia
Cost per year by activity 1 200 US$ (Millions) 1 000 A majority of the costs are from the 800 vaccination of sheep and goats 600 400 200 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 30 Coordination Ex ante assessment Surveillance Vaccination
Costs per small ruminant year by region (US$/head) 1,20 1,00 It is estimated that the strategy will 0,80 cost US$ 0.27 per small ruminant year 0,60 0,40 0,20 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Africa East Asia Middle East South Asia West Eurasia 31
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Costs per person by region (US$/person) 0,80 0,70 0,60 It is estimated that the strategy will 0,50 cost US$ 0.09 per person year 0,40 0,30 0,20 0,10 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Africa East Asia Middle East South Asia West Eurasia 33
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Comparison 35
Strategy Costs compared with current Status Quo • Estimated costs of current vaccination levels – the status quo - are estimated to be between US$ 212 to 365 million per year A cost benefit analysis of the strategy • Over a 15 year period this would mean a would use this figure of US$3.1 billion total cost of US$ 3.1 billion vaccine and as a benefit – a cost saved vaccine delivery • The status quo will NOT eradicate PPR – it will ensure a continual cost of vaccination 36
Key messages 37
Key issues – what to focus on • The costs of the programme are largely made up of vaccines and vaccine delivery • Vaccination needs to focus on populations at greatest risk and endemic foci • Good targeting and coordination will ensure cost management and potentially lead to cost savings • We need cost-effectiveness analysis during the strategy 38
Key issue – what is missing • The programmes at national level need to be supported by operational veterinary services • Additional investments will need to be made on infrastructure and human capacity 39
What will we get for this investment? • Better animal welfare • Improved levels of production • More stable supplies of meat, milk and wool • Reduced costs of treatment and vaccination • Improved consumer supplies 40
What will we get for this investment? • Veterinary services with the skill and experience to manage disease control in small ruminant populations This is a price worth • A small ruminant sector confident of its paying future • A consumer population with improved small ruminant product supply 41
For today’s consumers And for the consumers of the future 42
Thank you Jonathan Rushton Nick Lyons, João Afonso, Alana Bouton Professor of Animal Health Economics jrushton@rvc.ac.uk
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