Lessons and Implications from Endgame Financing Sample Clauses

Lessons and Implications from Endgame Financing. Although clear investment targets exist, the 2020 and 2030 goals set out an ambitious course to eliminate many NTDs, which will likely incur costly endgame financing. Here, endgame financing means the financing required for each endemic country to reach its relevant NTD goal of control, elimination, or eradication. As countries scale MDA and move into post- treatment surveillance, it may be more difficult to predict financing needs, a lesson learned from The Global Polio Eradication Initiative (GPEI). A review of GPEI identified sustaining funding and commitment through disease eradication as a critical challenge, especially when trying to transition to greater country ownership (Cochi, Xxxx, Xxxx, Xxxxxx, & Xxxxxx, 2016). Polio’s initial six-year plan with a $5.5B budget had to be expanded by approximately 27% to $7B through 2019 as efforts to eradicate polio in the hardest-to-reach regions continued. NTD stakeholders may similarly experience budget expansion and higher-than-expected financing needs if the intervention length, intervention cost, and other factors unexpectedly change. For example, the WHO estimates active NTD case-finding costs to range between $0.20 and $2.00 depending on the geography and population density (WHO, 2017b). Other studies have projected different financing and costing scenarios for PC-NTDs, highlighting the variability in financing requirements based on how quickly endemic countries progress towards their respective goals. In Xxx et al.’s micro-costing analysis for onchocerciasis costs, the onchocerciasis control scenario had higher projected costs ($3.9B economic) than the elimination ($2.9B) and eradication ($2.7B) scenarios (Xxx, Sicuri, & Tediosi, 2015). Although the elimination and eradication scenarios would incur greater surveillance costs, the authors concluded that transitioning out of the control phase would ultimately save costs from ongoing and prolonged MDA treatments. Conversely, Xxxxxxx et al.’s similar micro-costing analysis of LF programming predicted decreasing eradication financing costs based on the scale-up speed for post-MDA surveillance, capacity strengthening, and advocacy and communication ($1.24B for instantaneous, $1.27B for fast, $1.29B for average speed) (Xxxxxxx et al., 2017). Ultimately, these studies highlight the uncertainty and variability of NTD endgame financing; estimated costs will be affected by the timing of scale-up, the specific endgame goal (control, elimination, or eradication), an...