This peer-reviewed article explores the role of economic evaluation in public health emergency management (PHEM) in Africa, with a focus on the Africa Centres for Disease Control and Prevention (Africa CDC). The study uses a qualitative research design based on interviews with 12 Africa CDC division heads and senior technical advisors, complemented by a review of institutional documents and a logic model illustrating how economic evaluation can inform decision-making throughout the emergency management cycle.
The study examines how economic evaluation can support investment decisions, improve resource allocation, and strengthen the economic evidence available to policymakers managing disease outbreaks.
Key findings and insights
- Economic evaluation remains underutilized in outbreak preparedness and response. All 12 key informants recognized its importance across the public health emergency management cycle, from preparedness and early warning to outbreak control and post-emergency evaluation.
- Several priority areas for economic research were identified. These include assessing the return on investment of preparedness activities, evaluating the cost-effectiveness of diagnostic infrastructure, comparing alternative approaches to strengthening public health institutions, and monitoring national health expenditure commitments.
- Economic evidence can help make the case for investing before an outbreak occurs. Participants highlighted the need to quantify the economic benefits of preparedness investments relative to the costs of reactive outbreak responses, helping policymakers understand the value of allocating resources before emergencies arise.
- Limited technical and financial capacity constrains the use of economic evaluation. The main barriers identified were shortages of trained health economists, inadequate financial resources, and limited familiarity with health economics among decision-makers. The study identifies Africa CDC’s institutional position and partnerships as opportunities to strengthen the generation and use of economic evidence.
- Economic evaluation can support both technical decisions and policy advocacy. Beyond informing resource allocation, participants emphasized its potential to communicate the economic case for public health investments to senior policymakers and political decision-makers.
- The paper also draws on immunization economics as an example of how systematic economic evaluation can improve programme efficiency and increase the visibility of funding needs.
