Costs and financial feasibility of malaria elimination

Oliver Sabot, Justin M. Cohen, Michelle S. Hsiang, James G. Kahn, Suprotik Basu, Linhua Tang, Bin Zheng, Qi Gao, Linda Zou, Allison Tatarsky, Shahina Aboobakar, Jennifer Usas, Scott Barrett, Jessica L. Cohen, Dean T. Jamison, Richard G A Feachem

Research output: Contribution to journalReview articlepeer-review

84 Scopus citations


The marginal costs and benefits of converting malaria programmes from a control to an elimination goal are central to strategic decisions, but empirical evidence is scarce. We present a conceptual framework to assess the economics of elimination and analyse a central component of that framework - potential short-term to medium-term financial savings. After a review that showed a dearth of existing evidence, the net present value of elimination in five sites was calculated and compared with effective control. The probability that elimination would be cost-saving over 50 years ranged from 0 to 42, with only one site achieving cost-savings in the base case. These findings show that financial savings should not be a primary rationale for elimination, but that elimination might still be a worthy investment if total benefits are sufficient to outweigh marginal costs. Robust research into these elimination benefits is urgently needed.

Original languageEnglish (US)
Pages (from-to)1604-1615
Number of pages12
JournalThe Lancet
Issue number9752
StatePublished - Nov 6 2010

ASJC Scopus subject areas

  • Medicine(all)


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