The present value of human life losses associated with COVID-19 and likely productivity losses averted through COVID-19 vaccination in Madagascar

Abstract

Background As of 3 March 2023, Madagascar had conducted 525,461 COVID-19 tests, which revealed a total of 67,865 cases, comprising 66,433 recovered cases, ten active cases, and 1,422 deaths. To date, no study has attempted to estimate the total present value of human lives lost \(\left({TPVHL}_{MADAGASCAR}\right)\), productivity losses, and potential total productivity losses (or indirect costs) averted through COVID-19 vaccination for use in advocacy. The study reported in this paper attempted to bridge those information gaps. Methods A human capital model (HCM) was used to estimate the \({TPVHL}_{MADAGASCAR}\), i.e., sum of the discounted value of human life losses amongst persons in seven age groups \(\left({PVHL}_{i}\right)\): 1 = under 5 years, 2 = 5 to 14 years, 3 = 15 to 24 years, 4 = 25 to 34 years, 5 = 35 to 44 years, 6 = 45 to 59 years, and 7 = 60 years and older. Each age group \({PVHL}_{i=1,\dots ,7}\) was obtained through the multiplication of discount factor, undiscounted year of life, non-health gross domestic product (GDP) per capita, and age group’s number of COVID-19 deaths. To test the robustness of the results, the HCM was re-run five times, assuming (i) a 5% discount rate, (ii) a 10% discount rate, (iii) Africa’s highest average life expectancy at birth of 78.76 years (Algeria females), (iv) the world highest life expectancy of 88.17 years (Hong Kong females), and (v) projected excess COVID-19 mortality of 11,418.66. The projections of productivity losses averted through COVID-19 vaccination were done assuming 100%, 70%, 52.4%, and 8.266% coverage. Results The 1,422 human lives lost due to COVID-19 had a \({TPVHL}_{MADAGASCAR}\) of Int$ 46,485,587.15; and a mean of Int$ 32,690.28 per human life. Re-run of the model with (i) discount rates of 5% and 10% reduced \({TPVHL}_{MADAGASCAR}\) by 23.26% and 53%, respectively; (ii) average life expectancies of 78.76 years and 88.17 years grew \({TPVHL}_{MADAGASCAR}\) by 23.72% and 39.49%, respectively; (iii) projected excess COVID-19 mortality of 11,418.66 augmented \({TPVHL}_{MADAGASCAR}\) by 703%. Vaccinating 70% of the target population could potentially save the country Int$ 965,088,931 (1.71% of GDP). Conclusions COVID-19 pandemic has cost Madagascar substantive health and productivity losses. Potentially, the losses could be significantly reduced by optimizing COVID-19 vaccination coverage of the target population.