Defining the cost of the Egyptian lymphatic filariasis elimination programme

BACKGROUND: Lymphatic filariasis (LF) is targeted for global elimination. LF elimination programmes in different countries, including Egypt, are supported financially by national and international agencies. The national programme in Egypt is based on mass drug administration (MDA) of an annual dose of a combination of 2 drugs (DEC and albendazole) to all endemic villages. This study aimed primarily to estimate the Total and Government costs of two rounds of MDA conducted in Egypt in 2000 and 2001, the average cost per person treated, and the cost share of the different programme partners. METHODS: The Total costs reflect the overall annual costs of the MDA programme, and we defined Government costs as those expenditures made by the Egyptian government to develop, implement and sustain the MDA programmes. We used a generic protocol developed in coordination with the Emory Lymphatic Filariasis Support Center. Our study was concerned with all costs to the government, donors and other implementing parties. Cost data were retrospectively gathered from local, regional and national Ministry of Health and Population records. The total estimates for each governorate were based on data from a representative district for the governorate; these were combined with national programme data for a national estimate. RESULTS: The overall Total and Government costs for treating approximately 1,795,553 individuals living in all endemic villages in the year 2000 were US $3,181,000 and US $2,412,000, respectively. In 2001, the number of persons treated increased (29%) and the Total costs were US $3,109,000 while Government costs were US $2,331,000. In 2000, the average Total and Government costs per treated subject were US $1.77 and $1.34, respectively, however, these costs decreased to US $1.34 and $1.00, respectively in 2001. The coverage rate was 86.0% in 2000 and it increased to 88.0% in 2001. CONCLUSION: The Egyptian government provided 75.8% of all resources, as reflected in the Total cost estimates, and international agencies contributed the rest. Such data highlight both the commitment of the Egyptian government and the significance of the contributions of international bodies toward the LF elimination programme.