Submission ID 131648
| Issue/Objective | Despite their central role in preventing outbreaks and advancing global health equity, disease surveillance systems remain underfunded in low- and middle-income countries due to limited economic evidence demonstrating their value, leading to delayed outbreak detection and avoidable illness, particularly among vulnerable and underserved populations. This study aimed to quantify the economic return of Pakistan's Integrated Disease Surveillance and Response (IDSR) system and assess how such evidence can inform real-world investment decisions and restore commitment to action in fragmented and resource-constrained settings. |
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| Methodology/Approach | A Cost Benefit Analysis (CBA) was conducted using routine national surveillance data, applying a conservative transmission-based modelling framework informed by established epidemiological parameters. Using diarrheal disease as an exemplar within a multi-disease platform, cases and disability-adjusted life years (DALYs) averted were estimated relative to a no-surveillance counterfactual scenario, attributable to early detection and response triggered through IDSR. Health gains were monetized using country-specific thresholds, with proportional cost allocation. Sensitivity analyses assessed robustness across alternative assumptions. |
| Results | The IDSR system was associated with an estimated 433,576 cases averted annually, attributable to surveillance-triggered response, supporting earlier detection and response across districts. Under conservative assumptions, the benefit-cost ratio was 54.9:1, indicating that every £1 invested generated approximately £55 in health value. Findings remained robust across sensitivity scenarios, with benefit-cost ratios consistently above 1. These findings informed government planning decisions, with program expansion and sustained financing of surveillance activities following uptake of the results. |
| Discussion/Conclusion | By translating surveillance performance into measurable economic value and demonstrating policy uptake, this study addresses a critical barrier to investment in health systems. It provides a practical, scalable, and evidence-informed approach for low- and middle-income countries to justify financing of integrated surveillance systems. Embedding such approaches is essential to restoring commitment to action and strengthening equitable, resilient health systems in an increasingly fragmented and uncertain global context, particularly where delayed detection leads to avoidable illness and widening health inequities |
| Presenters and Affiliations | Muhammad Sartaj UK Health Security Agency Muhammad Asif Khan National Institute of Health Runa Khan Harvard TH Chan School of Public Health |
