Incentives for Reporting Disease Outbreaks

PLoS ONE 9(3): e90290. doi:10.1371/journal.pone.0090290

6 Pages Posted: 2 Aug 2015

See all articles by Ramanan Laxminarayan

Ramanan Laxminarayan

The Center for Disease Dynamics, Economics & Policy (CDDEP); Center for Disease Dynamics, Economics & Policy; Princeton University

Julian Reif

University of Illinois at Urbana-Champaign

Anup Malani

University of Chicago - Law School; University of Chicago Pritzker School of Medicine; Resources for the Future; National Bureau of Economic Research (NBER)

Date Written: March 2014

Abstract

Background: Countries face conflicting incentives to report infectious disease outbreaks. Reports of outbreaks can prompt other countries to impose trade and travel restrictions, which has the potential to discourage reporting. However, reports can also bring medical assistance to contain the outbreak, including access to vaccines.

Methods: We compiled data on reports of meningococcal meningitis to the World Health Organization (WHO) from 54 African countries between 1966 and 2002, a period is marked by two events: first, a large outbreak reported from many countries in 1987 associated with the Hajj that resulted in more stringent requirements for meningitis vaccination among pilgrims; and second, another large outbreak in Sub-Saharan Africa in 1996 that led to a new international mechanism to supply vaccines to countries reporting a meningitis outbreak. We used fixed-effects regression modeling to statistically estimate the effect of external forcing events on the number of countries reporting cases of meningitis to WHO.

Findings: We find that the Hajj vaccination requirements started in 1988 were associated with reduced reporting, especially among countries with relatively fewer cases reported between 1966 and 1979. After the vaccine provision mechanism was in place in 1996, reporting among countries that had previously not reported meningitis outbreaks increased.

Interpretation: These results indicate that countries may respond to changing incentives to report outbreaks when they can do so. In the long term, these incentives are likely to be more important than surveillance assistance in prompt reporting of outbreaks.

Keywords: disease outbreaks, meningitis, Hajj, vaccination, infectious disease reporting

JEL Classification: I15, I18, K32

Suggested Citation

Laxminarayan, Ramanan and Reif, Julian and Malani, Anup, Incentives for Reporting Disease Outbreaks (March 2014). PLoS ONE 9(3): e90290. doi:10.1371/journal.pone.0090290. Available at SSRN: https://ssrn.com/abstract=2638711

Ramanan Laxminarayan

The Center for Disease Dynamics, Economics & Policy (CDDEP) ( email )

1616 P St NW
Suite 600
Washington DC, DC 20036
United States

Center for Disease Dynamics, Economics & Policy ( email )

1616 P Street, NW
Washington, DC 20036
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HOME PAGE: http://www.cddep.org

Princeton University ( email )

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Princeton, NJ 08544-0708
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Julian Reif (Contact Author)

University of Illinois at Urbana-Champaign ( email )

601 E John St
Champaign, IL 61820
United States

HOME PAGE: http://www.julianreif.com

Anup Malani

University of Chicago - Law School ( email )

1111 E. 60th St.
Chicago, IL 60637
United States
773-702-9602 (Phone)
773-702-0730 (Fax)

HOME PAGE: http://www.law.uchicago.edu/faculty/malani/

University of Chicago Pritzker School of Medicine

Chicago, IL 60637
United States

Resources for the Future

1616 P Street, NW
Washington, DC 20036
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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