Infectious diseases remain the main cause of death in low-income countries. Because of this, efforts to control the circulation of infectious agents are a priority for public policy makers. This control is challenged by a combination of complex disease dynamics, funding constraints or lack of political and societal commitment. These challenges are generally heterogeneous between geographical settings making the impact of control strategies hard to assess.
In view of this, the purpose of this research is to integrate economic and epidemiological tools in order to improve support for disease control planning and implementation. To do this, I develop a metapopulation model framework to analyse the impact of control strategies when there are neighbouring populations with different epidemiological conditions. The results from this framework can be incorporated into further economic analysis and optimisations.
The first section of this project aims to understand interventions’ effects when transmission intensity varies between populations. As a first approach, I implement the framework to analyse indirect effects of interventions for a transmission-stratified population, using generic models. Then, to contextualise the findings from the generic model, I analyse optimal intervention allocation for malaria control. Results from this section evidenced the importance of aligning local and global control strategies.
The second section of this project focuses on understanding the consequences of disease control when intervention uptake varies between populations. For this, the metapopulation framework is applied to estimate the burden populations undergo due to the presence of an anti-vaccination movement. First, I analyse the burden of an outbreak of a vaccine preventable disease in a population where there are opposing vaccine acceptance views, implementing a measles transmission. Finally, I use the same approach to estimate the likely impact of vaccine hesitancy on the control of the COVID-19 pandemic. Results of this section highlight the importance of addressing vaccine hesitancy as a public health priorityOpen Acces
