MEHMET FERİT CAN, Cengiz YALÇIN

The cost-benefit analysis of alternative brucellosis control strategies in Turkey

Bruselloz zoonotik bir hastalıktır ve enfekte türlerde ciddi mali kayıplara yol açmaktadır. Bu çalışmanın amacı Türkiye için mali açıdan en rasyonel bruselloz kontrol stratejisinin maliyet-fayda analizleriyle belirlenmesidir. Çalışma kapsamında dört farklı enfeksiyon kontrol stratejisi iyimser, beklenen ve kötümser olmak üzere üç farklı senaryo altında dizayn edilmiştir. Türkiye için mali açıdan en rasyonel enfeksiyon kontrol seçeneğinin ikinci strateji olan “büyükbaş hayvanlar için üç-altı aylık dişilerin, küçükbaş hayvanlar için üç-altı aylık dişi ve erkek genç hayvanların aşılanması ve her bir türde hedef prevalans düzeyine ulaşıldıktan sonra aşılamanın sonlandırılarak aynı yıl test ve zorunlu kesim yöntemlerinin ülke genelinde uygulanması” olduğu belirlenmiştir. İkinci strateji kapsamında iyimser, beklenen ve kötümser senaryolar için net bugünkü değer sırasıyla -$3.1, $29.2 ve $41.9 milyon; fayda-maliyet oranı ise sırasıyla 0.86, 2.26 ve 2.84 olarak tahmin edilmiştir. Bu çalışmanın sonuçları brusellozla mücadelenin beklenen ve kötümser senaryolar için mali açıdan rasyonel olduğunu göstermiştir. Bununla beraber, mali açıdan rasyonel bir kontrol stratejisinin, her zaman için teknik olarak da uygun veya halk sağlığı açısından da rasyonel anlamı taşımayacağı unutulmamalıdır.

Türkiye’de alternatif bruselloz kontrol stratejilerinin maliyet-fayda analizi

Brucellosis is a zoonotic disease and leads to serious financial losses in infected species. The aim of this study is to determine the most financially rational brucellosis control strategy for Turkey by means of cost-benefit analyses. In this study, four different infection control strategies were designed under three different scenarios named optimistic, expected and pessimistic scenarios. The most financially rational infection control option for Turkey was found to be the second strategy, which is “only young animals, three to six month old female bovine and three to six month old male and female ovine, have been vaccinated and after reaching the target prevalence for each species, vaccinations will be terminated and in the same year test and compulsory slaughter methods will be implemented throughout the country”. For the optimistic, expected and pessimistic scenarios according to second strategy the net present value was estimated as -$3.1 million, $29.2 million and $41.9 million respectively, the benefit-cost ratio was estimated 0.86, 2.26 and 2.84 respectively. The results of this study indicated that fighting with brucellosis is financially rational for expected and pessimistic scenarios. However, it should not be forgotten that a financially rational control strategy doesn’t means that it is always suitable technically or it is rational in respect to public health.

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