Macroeconomic Impact of Ebola outbreaks in SSA and potential mitigation of GDP loss with prophylactic vaccination programs

Introduction: Decisions about prevention of and response to Ebola outbreaks require an understanding of the macroeconomic implications of these interventions. Prophylactic vaccines hold promise to mitigate the negative economic impacts of infectious disease outbreaks. The objective of this study was to evaluate the relationship between outbreak size and economic impact among countries with recorded Ebola outbreaks and to quantify the hypothetical benefits of prophylactic Ebola vaccination interventions in these outbreaks. Methods: The synthetic control method was used to estimate the causal impacts of Ebola outbreaks on per capita gross domestic product (GDP) of five countries in sub-Saharan Africa that have previously experienced Ebola outbreaks between 2000 and 2016, where no vaccines were deployed. Using illustrative assumptions about vaccine coverage, efficacy, and protective immunity, the potential economic benefits of prophylactic Ebola vaccination were estimated using the number of cases in an outbreak as a key indicator. Results: The impact of Ebola outbreaks on the macroeconomy of the selected countries led to a decline in GDP of up to 36%, which was greatest in the third year after the onset of each outbreak and increased exponentially with the size of outbreak (i.e., number of reported cases). Over three years, the aggregate loss estimated for Sierra Leone from its 2014-2016 outbreak is estimated at 16.1 billion International$. Prophylactic vaccination could have prevented up to 89% of an outbreak’s negative impact on GDP, reducing the outbreak’s impact to as little as 1.6% of GDP lost. Conclusion: This study supports the case that macroeconomic returns are associated with prophylactic Ebola vaccination. Our findings support recommendations for prophylactic Ebola vaccination as a core component of prevention and response measures for global health security.引言：埃博拉疫情的防控决策需要明晰相关干预措施的宏观经济影响。预防性疫苗有望减轻传染病暴发带来的负面经济冲击。本研究旨在评估有埃博拉暴发记录的国家中，疫情规模与经济影响之间的关联，并量化此类暴发中预防性埃博拉疫苗接种干预措施的潜在收益。 研究方法：本研究采用合成控制法（synthetic control method），估算2000年至2016年间曾暴发埃博拉疫情且未部署疫苗的5个撒哈拉以南非洲国家的埃博拉疫情对其人均国内生产总值（GDP）的因果影响。基于疫苗接种覆盖率、效力及保护免疫力的示范性假设，本研究以暴发病例数作为核心指标，估算预防性埃博拉疫苗接种的潜在经济收益。 研究结果：埃博拉疫情对所选国家宏观经济的影响致使其GDP最高下滑36%，该负面影响在疫情暴发后的第三年达到峰值，且随疫情规模（即报告病例数）呈指数级增长。以塞拉利昂2014-2016年的暴发为例，三年内该国的总经济损失预估达161亿国际元。预防性疫苗接种可避免疫情对GDP造成的高达89%的负面影响，将疫情的经济影响降至仅相当于GDP损失1.6%的水平。 研究结论：本研究证实，预防性埃博拉疫苗接种与宏观经济收益存在关联。我们的研究结果支持将预防性埃博拉疫苗接种作为全球卫生安全防控与应对措施的核心组成部分的相关建议。