A public choice framework for controlling transmissible and evolving diseases
- aDepartment of Biology, University of Washington, Seattle, WA 98195-1800; and
- bDepartment of Economics, University of California, Santa Barbara, CA 93106
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Edited by Peter T. Ellison, Harvard University, Cambridge, MA, and approved November 17,2009 (received for review July 23,2009)
Abstract
Control measures used to limit the spread of infectious disease often generate externalities. Vaccination for transmissible diseases can reduce the incidence of disease even among the unvaccinated, whereas antimicrobial chemotherapy can lead to the evolution of antimicrobial resistance and thereby limit its own effectiveness over time. We integrate the economic theory of public choice with mathematical models of infectious disease to provide a quantitative framework for making allocation decisions in the presence of these externalities. To illustrate, we present a series of examples: vaccination for tetanus, vaccination for measles, antibiotic treatment of otitis media, and antiviral treatment of pandemic influenza.
Footnotes
- ↵1To whom correspondence should be addressed. E-mail: cbergst{at}u.washington.edu.
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Author contributions: B.M.A., T.C.B., and C.T.B. designed research, performed research, analyzed data, and wrote the paper.
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This paper results from the Arthur M. Sackler Colloquium of the National Academy of Sciences, “Evolution in Health and Medicine” held April 2–3, 2009, at the National Academy of Sciences in Washington, DC. The complete program and audio files of most presentations are available on the NAS web site at www.nasonline.org/Sackler_Evolution_Health_Medicine.
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The authors declare no conflict of interest.
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This article is a PNAS Direct Submission.
