Table 1.
Annual costs of the 21 essential intervention packages in DCP3
| Baseline cost per capita | Baseline cost for overall population, billions US$ | Incremental cost per capita | Incremental cost for overall population, billions US$ | Total cost per capita | Total cost for overall population, billions US$ | Package share of total costs | ||
|---|---|---|---|---|---|---|---|---|
| Low-income countries | ||||||||
| Age-related | ||||||||
| 1. Maternal and newborn health (volume 2) | $1·1 | $1·0 | $1·6 | $1·4 | $2·7 | $2·4 | 5·0% | |
| 2. Child health (volume 2) | $1·9 | $1·7 | $0·92 | $0·82 | $2·8 | $2·5 | 5·3% | |
| 3. School-age health and development (volume 8) | $0·12 | $0·11 | $0·24 | $0·21 | $0·36 | $0·32 | 0·7% | |
| 4. Adolescent health and development (volume 8) | $0·39 | $0·35 | $0·55 | $0·50 | $0·94 | $0·85 | 1·8% | |
| 5. Reproductive health and contraception (volumes 1, 2, and 8) | $0·77 | $0·69 | $0·40 | $0·36 | $1·2 | $1·0 | 2·2% | |
| Infectious diseases | ||||||||
| 6. HIV and STIs (volume 6) | $2·3 | $2·0 | $4·0 | $3·6 | $6·3 | $5·7 | 11·9% | |
| 7. Tuberculosis (volume 6) | $0·39 | $0·36 | $0·17 | $0·15 | $0·56 | $0·51 | 1·1% | |
| 8. Malaria and adult febrile illness (volumes 2, 6, and 8) | $1·5 | $1·4 | $2·4 | $2·2 | $0·39 | $3·5 | 7·5% | |
| 9. Neglected tropical diseases (volume 6) | $0·22 | $0·20 | $0·62 | $0·56 | $0·84 | $0·75 | 1·6% | |
| 10. Pandemic and emergency preparedness (volume 9) | $0·015 | $0·014 | $0·68 | $0·61 | $0·72 | $0·65 | 1·4% | |
| Non-communicable disease and injury | ||||||||
| 11. Cardiovascular, respiratory, and related disorders (volume 5) | $0·85 | $0·76 | $15 | $13 | $15 | $14 | 29·2% | |
| 12. Cancer (volume 3) | $0·16 | $0·14 | $2·1 | $1·9 | $2·3 | $2·1 | 4·3% | |
| 13. Mental, neurological, and substance use disorders (volume 4) | $0·23 | $0·21 | $2·5 | $2·2 | $2·7 | $2·5 | 5·2% | |
| 14. Musculoskeletal disorders (volume 9) | $0·060 | $0·054 | $1·6 | $1·5 | $1·7 | $1·5 | 3·2% | |
| 15. Congenital and genetic disorders (volume 9) | $0·45 | $0·40 | $1·0 | $0·94 | $1·5 | $1·3 | 2·8% | |
| 16. Injury prevention (volume 7) | $0·0021 | $0·0019 | $0·049 | $0·044 | $0·051 | $0·046 | 0·1% | |
| 17. Environmental improvement (volume 7) | $0·044 | $0·040 | $0·050 | $0·045 | $0·094 | $0·084 | 0·2% | |
| Health services | ||||||||
| 18. Surgery (volume 1) | $0·27 | $0·24 | $4·8 | $4·4 | $5·1 | $4·6 | 9·7% | |
| 19. Rehabilitation (volume 9) | $0·12 | $0·11 | $1·9 | $1·7 | $2·0 | $1·8 | 3·7% | |
| 20. Palliative care and pain control (volume 9) | $0·11 | $0·10 | $1·6 | $1·5 | $1·7 | $1·6 | 3·3% | |
| 21. Pathology (volume 9) | $0·47 | $0·42 | $2·2 | $2·0 | $2·7 | $2·5 | 5·2% | |
| Totals | ||||||||
| Total service delivery costs | $11 | $10 | $42 | $38 | $53 | $47 | .. | |
| De-duplicated service delivery costs | $8·8 | $7·9 | $36 | $33 | $45 | $41 | 57·2% | |
| Total health system costs | $6·6 | $6·0 | $28 | $25 | $34 | $31 | 42·8% | |
| Total cost (sum of service delivery and health system costs) | $15 | $14 | $64 | $57 | $79 | $71 | 100% | |
| Lower-middle-income countries | ||||||||
| Age-related | ||||||||
| 1. Maternal and newborn health (volume 2) | $1·6 | $4·2 | $2·1 | $5·6 | $3·7 | $9·8 | 4·3% | |
| 2. Child health (volume 2) | $2·8 | $7·6 | $0·97 | $2·6 | $3·8 | $10 | 4·3% | |
| 3. School-age health and development (volume 8) | $0·11 | $0·29 | $0·25 | $0·67 | $0·36 | $0·96 | 0·4% | |
| 4. Adolescent health and development (volume 8) | $0·49 | $1·3 | $0·70 | $1·9 | $1·2 | $3·2 | 1·4% | |
| 5. Reproductive health and contraception (volumes 1, 2, and 8) | $1·8 | $4·9 | $0·50 | $1·3 | $2·3 | $6·3 | 2·8% | |
| Infectious diseases | ||||||||
| 6. HIV and STIs (volume 6) | $1·6 | $4·4 | $5·9 | $16 | $7·6 | $20 | 8·9% | |
| 7. Tuberculosis (volume 6) | $0·43 | $1·1 | $0·25 | $0·66 | $0·68 | $1·8 | 0·8% | |
| 8. Malaria and adult febrile illness (volumes 2, 6, and 8) | $4·0 | $11 | $2·2 | $5·8 | $6·1 | $16 | 7·3% | |
| 9. Neglected tropical diseases (volume 6) | $0·32 | $0·87 | $0·67 | $1·8 | $1·0 | $2·7 | 1·2% | |
| 10. Pandemic and emergency preparedness (volume 9) | $0·072 | $0·19 | $0·65 | $1·7 | $0·72 | $1·9 | 0·9% | |
| Non-communicable disease and injury | ||||||||
| 11. Cardiovascular, respiratory, and related disorders (volume 5) | $9·6 | $26 | $21 | $55 | $30 | $81 | 36·2% | |
| 12. Cancer (volume 3) | $0·21 | $0·57 | $1·3 | $3·6 | $1·5 | $4·1 | 1·8% | |
| 13. Mental, neurological, and substance use disorders (volume 4) | $0·59 | $1·6 | $6·3 | $17 | $6·8 | $18 | 8·1% | |
| 14. Musculoskeletal disorders (volume 9) | $0·28 | $0·75 | $3·4 | $9·1 | $3·6 | $9·7 | 4·3% | |
| 15. Congenital and genetic disorders (volume 9) | $0·48 | $1·3 | $1·5 | $4·1 | $2·0 | $5·4 | 2·4% | |
| 16. Injury prevention (volume 7) | $0·0053 | $0·014 | $0·16 | $0·43 | $0·17 | $0·44 | 0·2% | |
| 17. Environmental improvement (volume 7) | $0·012 | $0·33 | $0·11 | $0·30 | $0·18 | $0·49 | 0·2% | |
| Health services | ||||||||
| 18. Surgery (volume 1) | $0·87 | $2·3 | $6·5 | $17 | $7·4 | $20 | 8·7% | |
| 19. Rehabilitation (volume 9) | $0·43 | $1·1 | $3·9 | $10 | $4·3 | $11 | 5·1% | |
| 20. Palliative care and pain control (volume 9) | $0·057 | $0·15 | $0·51 | $1·4 | $0·57 | $1·5 | 0·7% | |
| 21. Pathology (volume 9) | $0·80 | $2·1 | $3·1 | $8·4 | $4·5 | $12 | 5·3% | |
| Totals | ||||||||
| Total service delivery costs | $26 | $69 | $59 | $160 | $85 | $230 | .. | |
| De-duplicated service delivery costs | $23 | $61 | $53 | $140 | $75 | $200 | 57·2% | |
| Total health system costs | $17 | $46 | $40 | $110 | $57 | $150 | 42·8% | |
| Total cost (sum of service delivery and health system costs) | $40 | $110 | $92 | $250 | $130 | $350 | 100% | |
All costs are in 2016 US dollars rounded to two significant figures. Baseline costs reflect intervention costs at current coverage. Incremental costs are those required to increase coverage of all interventions from baseline to 80%. Total costs are the sum of baseline costs and incremental costs and reflect the cost of sustaining all interventions at 80% coverage. The baseline cost estimate does not differentiate between public and private sources. The DCP3 volumes in which the essential packages are featured are indicated. Total costs in the final row are the sum of de-duplicated service delivery costs and total health system costs. The de-duplicated service delivery costs are substantially lower than the total service delivery costs because a number of interventions are (intentionally) included in more than one DCP3 essential package. The shares of costs presented for each of the 21 essential packages use the de-duplicated service delivery costs as the denominator; therefore the sum of these shares exceeds 100% because of duplication. However, the share of any given package can be interpreted as the remaining fraction of the total EUHC service delivery cost if the interventions in all other packages were removed. The shares of costs presented in the totals sections reflect the relative proportion of EUHC costs related to service delivery and to health system strengthening, with the sum of these two being the total cost of EUHC. DCP3=Disease Control Priorities, 3rd edition. STI=sexually transmitted infection. EUHC=essential universal health coverage.