Funds to Meet 2020 Goals. The WHO and World Bank have quantified the required investment and funding needed to meet the 2020 and 2030 goals. The WHO’s 2015 NTD Report on Investment estimated total investment targets around $18B and $34B through 2020 and 2030, respectively, excluding the cost of in-kind medicine donations (WHO, 2015b). These investment targets were developed by combining the coverage targets for the population requiring PC and other NTD interventions (e.g. vector control, veterinary health) with unit cost benchmarks for delivering interventions. The WHO also estimates that, “a new investment of $50M per year would fill 50% of the coverage gap in the least developed countries, reaching 130M people per year” (WHO, 2017b, p. 129). Of these interventions, PC will require the largest investment for the delivery of donated medicines at approximately $750M per year through 2020 and $300M per year for 2020-30, estimates that exclude the direct value of donated medicines ("Major infectious diseases," 2017). From the domestic funding perspective, these delivery costs account for less than 0.1% of domestic health spending for endemic country governments. Finally, in addition to the costs of drug delivery and other NTD interventions, an estimated $10M is needed to enable ESPEN’s critical coordinating operations and keep commitments on track (WHO, 2017b). These large-scale investment targets and projections are built on cost estimates for the delivery of the package of essential NTD medicines through MDA to the target population. Confirming the perception of NTDs as one of global health’s “best buys”, the cost to administer the package of drugs is less than $0.50 per patient per one round of MDA (ESPEN, 2017b). One 2016 study by Xxxxxxxxxxx et al. examined this often-cited $0.50 cost per patient to better understand the cost drivers and potential range of the financial and economic unit cost across different settings (Xxxxxxxxxxx et al., 2016). By performing a meta-regression on the MDA cost per person to predict country-specific unit cost benchmarks, Xxxxxxxxxxx et al. identified a high cost sensitivity to economies of scale through higher coverage rates and the use of local volunteers, all of which lowered unit costs. Median financial unit costs were $0.20 and median economic unit costs, which incorporated Ministry of Health (MOH) staff, facility, and vehicle time, were $0.40. These results support using the $0.50 cost per person estimate and acknowledges the ability to furthe...
