The Ebola virus epidemic in West Africa was the largest of its kind, resulting in more cases and deaths than all previous outbreaks combined. According to newly published study findings, the economic value of those who died is the most significant component of a new “more comprehensive” assessment of the epidemic that devastated to Guinea, Liberia and Sierra Leone, which found that it cost approximately $53.19 billion dollars.
“This Ebola outbreak was the most devastating and therefore the most costly, both in terms of lives lost and resources required for containment, treatment, and recovery,” Caroline Huber, MPH, associate director of policy and economics at Precision Health Economics, and colleagues wrote. “To our knowledge, current estimates have not incorporated key impacts of the burden. By including factors like the health care workforce, impacts on other diseases, long-term sequelae, and preparedness measures around the world, this study offers a more comprehensive view of the burden of the 2014-2016 outbreak, compared with the estimates found in our literature review.”
Huber and colleagues based their estimate on an analysis of peer-reviewed literature and reports produced by nonprofit or nongovernmental organizations. Their review identified six broad social components: the impact of the epidemic on the health care workforce; the cost of non-Ebola virus disease; the cost of long-term Ebola virus disease sequelae; the cost of treatment, infection control and screening outside West Africa; the cost of deploying human resources outside West Africa; and the cost of other social factors.
In estimating the economic cost of the people who died, Huber and colleagues used a measure called value of a statistical life (VSL) estimate. They applied findings from a previous study for Sierra Leone, which estimated a VSL of $577,000 for each resident, to estimate a social value of the deaths that occurred during the epidemic, including the 11,310 deaths directly attributed to Ebola.
According to study findings, the most significant economic burden was from deaths not attributed to Ebola, which cost approximately $18.8 billion. Comparatively, the economic cost of the epidemic was estimated to be $14 billion. Among the other estimated costs were $26 million and $67 million on health care and disease mitigation services spent by Guinea and Sierra Leone, respectively, in 2014; $23.4 million collectively spent by neighboring countries, including the Central African Republic, the Democratic Republic of the Congo, Senegal and Nigeria, to prevent spread over their borders. Huber and colleagues said the economic effects on trade and output for Guinea, Liberia and Sierra Leone were immediate, with the volume of staple crops reduced by 12% and the percentage of traders decreasing by 20%, an estimated loss of $2.8 billion.
Another recently published study showed that Liberia suffered a major economic disruption following the epidemic, with more than half of households reporting lower income during the epidemic. Researchers said this fluctuation may have been caused by market interruptions and price fluctuations or control measures imposed by the Liberian government to control the disease, which affected income in homes throughout the nation, not just in the affected area. Additionally, nearly 54% of households reported that their agricultural production decreased during the epidemic because of closing markets, fewer middle-men purchasing the goods for sale and less transport.
According to Huber and colleagues, recovery efforts also cost billion, with outside donors pledging $5.2 billion by the end of 2016 and Guinea, Liberia and Sierra Leone allocating an estimated $2.9 billion combined.
“While each of the affected countries has made significant strides toward economic and social recovery, it still may be too soon to fully comprehend the overall impact of the outbreak on the world,” the authors concluded. “Nevertheless, the greater understanding of the consequences and the costs borne by these communities, as well as the risk inherent to the wider world, are essential for our understanding of the importance and value of the development of interventions, such as vaccines, increases in health care infrastructure, and building public health capacity that might help mitigate future outbreaks of this, and other, devastating diseases.” – by Caitlyn Stulpin
Disclosures: Huber is an employee of Precision Health Economics, which receives funding from life sciences companies to conduct research. Please see the study for all other authors’ relevant financial disclosures.