Cost-benefit analysis: comparisons of investments in improved water supply and cholera vaccination programmes

Updated - Friday 15 May 2009

Researchers say they have conducted the first cost–benefit comparison of improved water supply investments and cholera vaccination programmes [1]. They compared two water supply interventions – deep wells with public hand pumps and biosand filters – with two types of cholera immunization programmes – general community-based and targeted school-based programmes.

The two improved water supply interventions and the targeted cholera vaccination programme were found to be much more likely to yield attractive cost–benefit outcomes than a community-based vaccination programme. Implementing community-based cholera vaccination programmes after borehole + hand pump or biosand filters have already been installed is rarely justified because biosand filters achieve substantial cholera risk reductions on their own. On the other hand, implementing school-based cholera vaccination programmes after the installation of boreholes with hand pump is more likely to be economically attractive. Also, first investing in cholera vaccinations, then subsequently investing in water interventions is still likely to yield positive economic outcomes because other health and non-health benefits.

However, cholera vaccination programmes are more equitable than water supply interventions because more people can receive benefits with a given budget. Also in the densely crowded slums of South Asian and African cities where there may be insufficient space for some point-of-use technologies, and where non-networked water supply options are limited, cholera vaccination programmes may be more practical.

[1] Jeuland, M, and Whittington, D. (2009) Cost-benefit comparisons of investments in improved water supply and cholera vaccination programs. Vaccine ; vol. 27, no. 23 ; p. 3109-3120. doi:10.1016/j.vaccine.2009.02.104

Related news:

Household water treatment: scaling-up is premature say researchers, Source Weekly, 13 Mar 2009 ;
Hygiene behaviour: an eleven country review of handwashing with soap, Source Weekly, 22 Apr 2009

Related web site: WHO - Cholera vaccines

Contact: Marc Jeuland, University of North Carolina at Chapel Hill, USA, jeuland@email.unc.edu