Economic Impact of TB Mortality in 120 Countries and What It Will Cost If We Don't Achieve the End TB Targets: A Full-Income Analysis

Abstract

Background: Meeting the End TB mortality target by 2030, a 90% reduction compared to 2015 levels seems increasingly improbable. To assess the economic impact of not meeting the End TB mortality target by 2030, and alternatively 2045, a full income economic analysis was performed, using data from 120 countries. Methods: Mortality risk reductions were calculated based on the End TB mortality target being met in 2030 and 2045. The annual mortality risk change at each age interval, was converted into full-income risk, multiplying the rescaled population mortality risk change by the value-of-a-statistical-life year, computed as a proportion of Gross Domestic Product (GDP). The Cost of Inaction was calculated as the difference in full-income losses if the End TB target is met in 2030 compared to 2045. Impact on life expectancies, at birth and at age 35, were also estimated for these different end dates. Results: From 2020 to 2050, based on current trends, there would be 31.8 million TB deaths and full-income losses amounting to US$17.5 trillion (mean=US$230 million; SD=US$26 billion). If the End TB mortality target is met in 2030, US$13.2 trillion of the losses can be avoided. If met in 2045, US$10.2 trillion can be avoided. The additional cost of not meeting the End TB target until 2045 would be 5.7 million deaths and US$2.96 trillion in economic losses. Interpretation: Failure to achieve the End TB mortality target by 2030 will lead to profound full-income losses. The impact of delay will be greatest in sub-Saharan Africa where full-income losses in 15 countries will contribute more than 10% of annual GDP reduction. Impacted countries, donor nations and the private sector should redouble efforts to finance TB programs and research, since the economic dividend of such strategies is likely to be profound.Funding Statement: This analysis was undertaken without extramural funding.Declaration of Interests: The authors declare that we have no conflicts of interest.