Costs of services and funding gap of the Bangladesh National Tuberculosis Control Programme 2016-2022: An ingredient based approach

Md Zahid Hasan; Sayem Ahmed; Zeenat Islam; Farzana Dorin; Md Golam Rabbani; Gazi Golam Mehdi; Mohammad Wahid Ahmed; Tazeen Tahsina; Shehrin Shaila Mahmood; Ziaul Islam

doi:10.1371/journal.pone.0286560

Costs of services and funding gap of the Bangladesh National Tuberculosis Control Programme 2016-2022: An ingredient based approach

PLoS One. 2023 Jun 2;18(6):e0286560. doi: 10.1371/journal.pone.0286560. eCollection 2023.

Authors

Affiliations

¹ Health Economics and Financing, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
² Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom.
³ Health Economics and Health Technology Assessment (HEHTA), Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom.
⁴ Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

Abstract

Background: Bangladesh National Tuberculosis (TB) Control Programme (NTP) has deployed improved diagnostic technologies which may drive up the programme costs. We aimed to estimate the supply-side costs associated with the delivery of the NTP and the funding gap between the cost of implementation and available funding for the Bangladesh NTP.

Methods: An ingredient-based costing approach was applied using WHO's OneHealth Tool software. We considered 2016, as the base year and projected cost estimates up to 2022 using information on NTP planned activities. Data were collected through consultative meetings with experts and officials/managers, review of documents and databases, and visits to five purposively selected TB healthcare facilities. The estimated costs were compared with the funds allocated to the NTP between 2018 and 2022 to estimate the funding gap.

Findings: The estimated total cost of NTP was US$ 49.22 million in 2016, which would increase to US$ 146.93 million in 2022. Human resources (41.1%) and medicines and investigations/ supplies (38.0%) were the major two cost components. Unit costs were highest for treating extensively drug-resistant TB at US$ 7,422.4 in 2016. Between 2018-2022, NTP would incur US$ 536.8 million, which is US$ 235.18 million higher than the current allocation for NTP.

Conclusion: Our results indicated a funding gap associated with the NTP in each of the years between 2018-2022. Policy planners should advocate for additional funding to ensure smooth delivery of TB services in the upcoming years. The cost estimates of TB services can also be used for planning and budgeting for delivering TB services in similar country contexts.

Copyright: © 2023 Hasan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Bangladesh
Budgets*
Extensively Drug-Resistant Tuberculosis*
Humans

Grants and funding

This work was supported by the United States Agency for International Development (USAID) under the terms of the USAID’s Research for Decision Makers (RDM) Activity cooperative agreement [AID-388-A-17-00006]. icddr,b acknowledges with gratitude the commitment of USAID’s RDM activity to its research efforts and funding for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.