Economics and Communicable Diseases: An overview of Issues

Infectious diseases are the largest cause of mortality worid-wide and in 1997 were responsible for one third of total deaths. Despite this, there has been little discussion of infectious disease by health economists. This undoubtedly reflects the concentration of infection related deaths in developing countries and their relative unimportance in the west. Partly because of the AIDS epidemic there has been increasing interest in the area and a number of recent studies have examined the unique issues arising from 'economic epidemiology'. This literature is reviewed. Infectious diseases have also been the subject of on going cost effectiveness analyses and, in the second half of the paper, these and associated issues are discussed. The need for methodological standardisation in these studies is noted. It is argued that the priority accorded to studies of infectious diseases may be illegitimately compromised if priority setting is based upon the total burden of each disease and that this error may be the result of an excessive focus upon interventions for diseases associated with designated areas of national priority.