Methodological development in whole-economy modelling: P. falciparum malaria control in Africa

决策者对经济证据的需求很大，而且越来越大，用于表明疾病的相对负担、负担的分布以及影响疾病的具体干预措施的可取性。这些证据绝大多数是通过测量对个人、家庭和卫生部门的影响，然后将这些影响扩大到代表国家影响的研究产生的。然而，这种分析在充分探讨疟疾等具有广泛影响的疾病的经济影响方面是有限的，疟疾从劳动力供应、旅游业和外国投资等多个角度影响经济。以前的工作已经证明了可计算一般均衡方法对模拟这些更广泛的影响的价值，但强调需要进一步发展其在健康问题上的应用;特别是，将经济模型与疾病的流行病学和人口统计学相结合。非洲的疟疾控制为这种方法学发展工作提供了理想的案例研究，因为它是全球最常见的传染病之一。非洲尤其受到严重影响，对疟疾和疟疾控制政策的经济分析已经证明有其局限性。事实上，最近有人提出？考虑到对旅游业和投资的影响等因素，进行更有力的分析，应成为研究的优先事项？（Lancet，2008; 371：1634）。这里提议的发展工作将在加纳和莫桑比克进行，这反映了疟疾流行病学的东西区域差异，总的来说，这个项目将产生一个适用于非洲各国的疟疾（控制）模式。连同现有的工作，该项目将进一步促进适用于广泛的传染病，病原体和发达国家和发展中国家的建模能力，促进卫生经济学中更广泛地应用这种形式的建模，并增加其相关性卫生政策。

The demand for economic evidence by policy makers is strong and increasing, used to indicate the relative burden of diseases, the distribution of that burden, and the desirability of specific interventions to affect disease. Such evidence is overwhelmingly generated by studies that measure affects upon individuals, households and the health sector and then scale these up to represent national impacts. However, such analysis is limited in exploring fully the economic impact of a disease with widespread effects, such as malaria, which impacts upon the economy from a number of angles, such as labour supply, tourism and foreign investment. Previous work has demonstrated the value of the Computable General Equilibrium (CGE) approach to modeling these wider effects, but highlighted the need for further development in its application to health issues; specifically, integration of the economic modeling with the epidemiology and demography of disease.Malaria control in Africa provides the ideal case-study for this methodological developmental work, as it is one of the most common global infectious diseases. Africa especially is heavily affected, and economic analyses of malaria and malaria control policies have been demonstrated to have limitations. Indeed, it has been recently suggested that ?more robust analysis, taking into account factors such as effect on tourism and investment, should be a research priority? (Lancet, 2008; 371: 1634). The developmental work proposed here will take place in Ghana and Mozambique, which reflect the East-West regional differences in malaria epidemiology.Overall, this project will produce a model of malaria (control) applicable across a range of African counties. Together with existing work, this project will further contribute to a modeling capability applicable across a wide range of infectious diseases, causative agents and developed and developing countries, facilitating the wider application of this form of modeling within health economics, and increasing its relevance to health policy.