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05/03/2023
Economics & the Zika virus
Stefano BertozziUC Berkeley School of Public Health
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Potential Macro-economic Impact of the Zika VirusWorld Bank estimates, 2/16• Potential impact for the Latin American and Caribbean
region could reach $3.5 billion in 2016– 0.06% of annual GDP across the region– Impact on already troubled economies in the region
• Economic impact expected in the short and longer terms– Short term impact on potential decline in tourism
(plane ticket bookings are down 3.4%)– Longer-term impact due to delayed child-bearing in a
region where population growth rates are already slowingWorld Bank. The short-term economic costs of Zika in
Latin America and the Caribbean (LCR), 2/18/16
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World Bank. The short-term economic costs of Zika in Latin America and the Caribbean (LCR), 2/18/16
Short-term (2016) Economic Impact of Zika
Income foregone Fiscal revenues foregone
USD Mn % of GDP USD Mn % of GDPLatin America and Caribbean 3478 0.06 420 0.01
Largest impacts in USD
Mexico 744 0.06 80 0.01
Cuba 664 0.86 na na
Dominican Republic 318 0.50 43 0.07
Brazil 319 0.01 75 0.00
Argentina 229 0.04 72 0.01
Significant Impacts, as % of GDP
Belize 21 1.22 5 0.29
Cuba 664 0.86 na na
Jamaica 112 0.81 27 0.19
Dominica 4 0.77 1 0.18
Dominican Republic 318 0.50 43 0.07
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Cost-Effectiveness Estimates: Considerations • Decision making with multiple unknowns
– Incidence of adverse outcomes (microcephaly and Guillain-Barré)– Potential of multifactoral causes of both
• Potential for significant heterogeneity in incidence of adverse outcomes– Window of vulnerability in pregnancy– Duration of sexual transmission risk– Durability of immunity following infection– Sensitivity/specificity of serological testing (now and in the future)
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Cost-Effectiveness of Prevention Options• Primary prevention
– Vaccine Development – up to a 10 year horizon• CE of development; CE of different implementation strategies
6PTRS = P(Technical & Regulatory Success)
Cost-Effectiveness of Zika Vaccine Development
Cos
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Zika vaccines would, however, face the same problem as vaccines for chikungunya, West Nile, St. Louis encephalitis, and other arboviruses: since epidemics appear sporadically and unpredictably, preemptively vaccinating large populations in anticipation of outbreaks may be prohibitively expensive and not cost-effective, yet vaccine stockpiling followed by rapid deployment may be too slow to counter sudden explosive epidemics.
Source: Zika Virus in the Americas —Anthony S. Fauci, M.D., and David M. Morens, M.D. “Yet Another Arbovirus Threat” N Engl J Med 2016
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Cost-Effectiveness of Prevention Options• Primary prevention
– Vaccine Development – up to a 10 year horizon• CE of development; CE of different implementation strategies
– Vector control of Aedes aegypti addresses three diseases: dengue, chikungunya and Zika• Decrease dengue and it may reduce the severity of Zika?• Decrease the attack rate and potentially increase the
probability of Zika infection during pregnancy in the future
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http://www.jpeds.com/cms/attachment/2021836512/2041795202/gr2_lrg.jpg
http://www.medscape.com/viewarticle/849515
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Cost-Effectiveness of Prevention Options• Primary prevention
– Vaccine Development – up to a 10 year horizon• CE of development; CE of different implementation strategies
– Vector control of Aedes aegypti addresses three diseases: dengue, chikungunya and Zika• Decrease the attack rate and potentially increase the
probability of Zika infection during pregnancy in the future• Decrease dengue and it may reduce the severity of Zika?
• Secondary prevention– Family planning (or travel to low-risk location) until vaccine
available– Serologic testing & family planning
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% of Women Seropositive prior to Pregnancy
Cost-Effectiveness of Family Planning
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Preg
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Wom
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% of Women Seropositive prior to Pregnancy
Inci
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Preg
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Cost-Effectiveness of Adding Screening to Family Planning
