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GLOBAL BURDEN OF TRACHOMA AND ECONOMICS OF THE DISEASE

Interest in the economics of trachoma is high because of the refinement of a strategy to control trachomatous blindness, an ongoing global effort to eliminate incident blindness from trachoma by 2020, and an azithromycin donation program that is a component of trachoma control programs in several countries. This report comments on the economic distribution of blindness from trachoma and adds insight to published data on the burden of trachoma and the comparative costs and effects of trachoma control. Results suggest that 1) trichiasis without visual impairment may result in an economic burden comparable to trachomatous low vision and blindness so that 2) the monetary burden of trachoma may be 50% higher than conservative, published figures; 3) within some regions more productive economies are associated with less national blindness from trachoma; and 4) the ability to achieve a positive net benefit of trachoma control depends importantly on the cost per dose of antibiotic.

Received July 30, 2003. Accepted for publication August 29, 2003.

Acknowledgments: We thank Jeff Mecaskey for comments on an earlier version of this paper, his input on the concept of equity and trachoma, and his continued interest in the economics of trachoma.

Financial support: The work on this paper was supported by a grant from the International Trachoma Initiative.

Authors’ addresses: Kevin D. Frick, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 606, Baltimore MD 21205-1901, Telephone: 410-614-4018, Fax: 410-955-0470, E-mail: kfrick{at}jhsph.edu. Christy L. Hanson, PO Box 27794 Washington, DC 20038, Telephone: 202-458-2159, Fax: 202-473-8107, E-mail: chanson{at}jhsph.edu. Gretchen A. Jacobson, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 654, Baltimore MD 21205-1901, Telephone: 410-955-6562, Fax: 410-955-0470, E-mail: gjacobso{at}jhsph.edu.

Reprint requests: Kevin D. Frick, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 606, Baltimore MD 21205-1901.