The health and economic benefits of the global programme to eliminate lymphatic filariasis (2000–2014)

Background:Lymphatic filariasis(LF),also known as elephantiasis,is a neglected tropical disease(NTD)targeted for elimination through a Global Programme to Eliminate LF(GPELF).Between 2000 and 2014,the GPELF has delivered 5.6 billion treatments to over 763 million people.Updating the estimated health and economic benefits of this significant achievement is important in justifying the resources and investment needed for eliminating LF.Method:We combined previously established models to estimate the number of clinical manifestations and disability-adjusted life years(DALYs)averted from three benefit cohorts(those protected from acquiring infection,those with subclinical morbidity prevented from progressing and those with clinical disease alleviated).The economic savings associated with this disease prevention was then analysed in the context of prevented medical expenses incurred by LF clinical patients,potential income loss through lost-labour,and prevented costs to the health system to care for affected individuals.The indirect cost estimates were calculated using the human capital approach.A combination of four wage sources was used to estimate the fair market value of time for an agricultural worker with LF infection(to ensure a conservative estimate,the lowest wage value was used).Results:We projected that due to the first 15 years of the GPELF 36 million clinical cases and 175(116–250)million DALYs will potentially be averted.It was estimated that due to this notable health impact,US$100.5 billion will potentially be saved over the lifetimes of the benefit cohorts.This total amount results from summing the medical expenses incurred by LF patients(US$3 billion),potential income loss(US$94 billion),and costs to the health system(US$3.5 billion)that were projected to be prevented.The results were subjected to sensitivity analysis and were most sensitive to the assumed percentage of work hours lost for those suffering from chronic disease(changing the total economic benefit between US$69.30–150.7 billion).Conclusions:Despite the limitations of any such analysis,this study identifies substantial health and economic benefits that have resulted from the first 15 years of the GPELF,and it highlights the value and importance of continued investment in the GPELF.

A CRANE AMONG THE CHICKENS?: EVALUATING A TEACHER TRAINING PROGRAMME

"Sometimes you try to share the ideas, they even turn up their noses at you, describing you as ’trying to be a crane among the chicks’." This rather forlorn comment comes from a middle school English teacher recently returned to his school in a remote province of China, full of enthusiasm for the new methods of teaching English gathered over two years away on a teacher-training course held in Shanghai. It gives the title to a recently published study of the fate that met this teacher and others like him after they had completed their course. Conducted by staff at Shanghai International Studies University (SISU), this set out to contribute to the evaluation of two in-service training courses for teachers of English held at that university through a follow-up study of former trainees. The study took place under the auspices of the Chinese State Education Commission and the British Overseas Development Administration, as did the two courses themselves. The most recent of these was a senior middle school teacher training (SMSTT) course for teachers working in less developed areas of China. This two-year course, designed and run at five universities, is still in operation at SISU and formed the primary focus of attention of the study. The other was a one-year course in advanced teacher training (ATT) for lecturers in higher education.