Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: a full-income analysis.
Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: a full-income analysis.
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DOI：
10.1016/s2214-109x(21)00299-0
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发表时间：
2021-10
期刊：
影响因子：
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通讯作者：
Reid M
中科院分区：
文献类型：
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作者：
Silva S;Arinaminpathy N;Atun R;Goosby E;Reid M
联合国可持续发展目标(SDGs)的结核病目标要求到2030年将结核病死亡人数比2015年减少90%，但现在看来，实现这一目标非常不可能。为了评估到2045年才能实现目标的经济影响，我们估计了120个国家在2020-50年期间的全额收入损失，其中包括那些因与新冠肺炎有关的结核病服务中断而导致的过度死亡。估计了120个国家从2020年到2050年每一年每个年龄段的年度死亡风险变化。然后，通过计算人口死亡率风险变化并乘以每个国家和年份的统计寿命年值，将这种风险变化转换为全收入风险。作为一个比较对象，我们假设当前的肺结核发病率在整个分析期间继续下降。我们计算了在2030年和2045年实现可持续发展目标的情景下，出生时和35岁时的全收入损失和人均预期寿命损失。我们将不作为的成本定义为这两种情况下全额收入损失和结核病死亡率的差异。根据目前结核病死亡人数每年下降2%的水平，从2020年到2050年，预计将发生3180万例结核病死亡病例(95%的不确定区间为2520万-3950万)，相应的经济损失为17.5万亿美元(14.9万亿-20.4万亿)。如果2030年实现可持续发展目标，可避免2380万结核病死亡(1890万-2950万)和13.1万亿美元(11.2万亿-15.3万亿)的经济损失。如果在2045年实现这一目标，就可以避免1810万结核病死亡(1430万-2240万)和10.2万亿美元(8.7万亿-11.8万亿)。因此，在2045年之前不能实现可持续发展目标结核病死亡率目标的代价是570万结核病死亡(510万-810万)和3.0万亿美元(2.5万亿-3.5万亿)的经济损失。与新冠肺炎相关的中断使这一成本增加了2903亿美元(2602亿-5700亿美元)。如果不能在2030年前实现可持续发展目标的结核病死亡率目标，将导致严重的经济和健康损失。拖延的影响将在撒哈拉以南非洲地区最大。受影响国家、捐助国和私营部门应加倍努力资助结核病规划和研究，因为此类战略的经济红利可能是巨大的。没有。
The tuberculosis targets for the UN Sustainable Development Goals (SDGs) call for a 90% reduction in tuberculosis deaths by 2030, compared with 2015, but meeting this target now seems highly improbable. To assess the economic impact of not meeting the target until 2045, we estimated full-income losses in 120 countries, including those due to excess deaths resulting from COVID-19-related disruptions to tuberculosis services, for the period 2020–50. Annual mortality risk changes at each age in each year from 2020 to 2050 were estimated for 120 countries. This risk change was then converted to full-income risk by calculating a population-level mortality risk change and multiplying it by the value of a statistical life-year in each country and year. As a comparator, we assumed that current rates of tuberculosis continue to decline through the period of analysis. We calculated the full-income losses, and mean life expectancy losses per person, at birth and at age 35 years, under scenarios in which the SDG targets are met in 2030 and in 2045. We defined the cost of inaction as the difference in full-income losses and tuberculosis mortality between these two scenarios. From 2020 to 2050, based on the current annual decrease in tuberculosis deaths of 2%, 31·8 million tuberculosis deaths (95% uncertainty interval 25·2 million–39·5 million) are estimated to occur, corresponding to an economic loss of US$17·5 trillion (14·9 trillion–20·4 trillion). If the SDG tuberculosis mortality target is met in 2030, 23·8 million tuberculosis deaths (18·9 million–29·5 million) and $13·1 trillion (11·2 trillion–15·3 trillion) in economic losses can be avoided. If the target is met in 2045, 18·1 million tuberculosis deaths (14·3 million–22·4 million) and $10·2 trillion (8·7 trillion–11·8 trillion) can be avoided. The cost of inaction of not meeting the SDG tuberculosis mortality target until 2045 (vs 2030) is, therefore, 5·7 million tuberculosis deaths (5·1 million–8·1 million) and $3·0 trillion (2·5 trillion–3·5 trillion) in economic losses. COVID-19-related disruptions add $290·3 billion (260·2 billion–570·1 billion) to this cost. Failure to achieve the SDG tuberculosis mortality target by 2030 will lead to profound economic and health losses. The effects of delay will be greatest in sub-Saharan Africa. Affected countries, donor nations, and the private sector should redouble efforts to finance tuberculosis programmes and research because the economic dividend of such strategies is likely to be substantial. None.