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THE DISEASES − CHAPTER 4
71
Investment case
The socioeconomic impact of Buruli ulcer is high. A study conducted in Ghana in
2012 showed the high burden on household costs of out-patient treatment despite its
availability free of charge. 1 Medical costs made up less than 4% of total direct costs. The
largest cost (81% of direct costs) was transportation. More difficult to quantify financially
was the cost of lost productivity (more than 8 days per patient), school absenteeism (19 days
per child) and social isolation (self-reported by 84% of children). In Central Cameroon,
the cost of hospitalization has been estimated at 25% of household annual earnings, again
despite treatment being available free of charge. 2
Investment targets for active case-finding, treatment and care of Buruli
ulcer (excluding medicines), 2015–2030
6
Constant US$ millions
4
2
0
2015
2020
Year
2025
2030
Notes: Shaded areas reflect the range determined by low and high values of the unit cost benchmarks; they do not
reflect uncertainty about future rates of scale-up and scale-down of interventions. All numbers expressed in US$ are
constant (real) US$, adjusted to reflect purchasing power in the United States of America in 2015.
Buruli ulcer is known to be severely underreported. 3,4 Prevention of disability will require
increased public investment in early case detection. To prevent catastrophic expenditure of
those cases that are found, public investment in treatment and care is also needed. If targets
of coverage and value for money are met, about US$ 4.3 million (US$ 3.8–4.8 million) per
year may be required during 2015–2030 for active case-finding, diagnosis, treatment and
care, including medicines and surgery when necessary. This covers only the direct medical
costs, not the cost of transportation.
The development of a new rapid diagnostic test offers new investment opportunities.
Currently, clinical diagnosis relies on well-trained, experienced health professionals;
laboratory confirmation by polymerase chain reaction (PCR) can be done only in reference
laboratories. Fluoroscent thin-layer chromatography has potential as an important new