A simulation approach to financing schistosomiasis control in China

Abstract

The objectives of the study are to simulate the predicted "resource gap" which will follow a World Bank Loan Programme for schistosomiasis control in China using the cost information and to derive policy implications for financing the programme in the future. Firstly, methodologies and cost models for calculating the cost and unit costs of different control options have been established. Using hypothetical and actual cost data of the schistosomiasis control programme in China, the study simulated and analyzed the resource adequacy after the termination of the World Bank Loan programme under different scenarios. It is concluded that financial constraints would occur once the Bank Loan finishes. Government financing for the programme would be inadequate even to maintain the level that pertained before the start of the loan programme. Further, in reviewing the financing mechanisms of the current control programme, it is realized that government financing is unlikely to increase substantially based on the situational analysis. On the other hand, the current attempt to integrate snail control into agriculture or aquaculture production projects is evaluated high as an alternative financing scheme for continuing the programme in certain regions. External financing was not and will not and will not be the principal and reliable financing mechanism for China's schistosomiasis control programme. Based on the above analysis, some important policy implications for the current financing problems of the programme are derived and discussed. It is recommended that health planners should still rank control of the disease as high priority. new delivery structure to integrate the control programme into primary health care should be probed. Community involement for local control activities should be pursued with regard to the possibilities of cost sharing and community financing. The current drug/molluscicides production/importing policies should be reviewed. The domestic production of praziquantel should be oriented to provide the domestic market, while the factory producing niclosamide should continue its production but reduce the cost.