Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa

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Title: Modelling the cost-effectiveness of introducing the RTS,S malaria vaccine relative to scaling up other malaria interventions in sub-Saharan Africa
Authors: Winskill, P
Walker, P
Griffin, J
Ghani, A
Item Type: Journal Article
Abstract: Objectives: To evaluate the relative cost-effectiveness of introducing the RTS,S malaria vaccine in sub-Saharan Africa compared with further scale-up of existing interventions. Design: A mathematical modelling and cost-effectiveness study. Setting: Sub-Saharan Africa. Participants: People of all ages. Interventions: The analysis considers the introduction and scale-up of the RTS,S malaria vaccine and the scale-up of long lasting insecticide treated bed nets (LLINs), indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC). Main outcome measure: The number of Plasmodium falciparum cases averted in all age groups over a ten year period. Results: Assuming access to treatment remains constant, increasing coverage of LLINs was consistently the most cost-effective intervention across a range of transmission settings and was found to occur early in the cost-effectiveness scale-up pathway. IRS, RTS,S and SMC entered the cost-effective pathway once LLIN coverage had been maximised. If non-linear production functions are included to capture the cost of reaching very high coverage, the resulting pathways become more complex and result in selection of multiple interventions. Conclusions: RTS,S was consistently implemented later in the cost-effectiveness pathway than the LLINs, IRS and SMC but was still of value as a fourth intervention in many settings to reduce burden to the levels set out in the international goals.
Issue Date: 24-Jan-2017
Date of Acceptance: 18-Nov-2016
ISSN: 2059-7908
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Global Health
Volume: 2
Issue: 1
Copyright Statement: © 2017 The Authors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:
Sponsor/Funder: PATH-Program for Appropriate Technology in Health
Bill & Melinda Gates Foundation
Medical Research Council (MRC)
Medical Research Council (MRC)
Funder's Grant Number: GAT.0888-07-06258-CRT
Publication Status: Accepted
Article Number: e000090
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care

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