Malaria continues to be a public health problem in South Africa. While the disease is mainly confined to three of the nine provinces, most local transmissions occur because of importation of cases from neighbouring countries. The government of South Africa has reiterated its commitment to eliminate malaria within its borders. To support the achievement of this goal, this study presents a cost–benefit analysis of malaria elimination in South Africa through simulating different scenarios aimed at achieving malaria elimination within a 10-year period. A dynamic mathematical transmission model was developed to estimate the costs and benefits of malaria elimination in South Africa between 2018 and 2030. The model simulated a range of malaria interventions and estimated their impact on the transmission of Plasmodium falciparum malaria between 2018 and 2030 in the three endemic provinces of Limpopo, Mpumalanga and KwaZulu-Natal. Local financial, economic, and epidemiological data were used to calibrate the transmission model. Based on the three primary simulated scenarios: Business as Usual, Accelerate and Source Reduction, the total economic burden was estimated as follows: for the Business as Usual scenario, the total economic burden of malaria in South Africa was R 3.69 billion (USD 223.3 million) over an 11-year period (2018–2029). The economic burden of malaria was estimated at R4.88 billion (USD 295.5 million) and R6.34 billion (~ USD 384 million) for the Accelerate and Source Reduction scenarios, respectively. Costs and benefits are presented in midyear 2020 values. Malaria elimination was predicted to occur in all three provinces if the Source Reduction strategy was adopted to help reduce malaria rates in southern Mozambique. This could be achieved by limiting annual local incidence in South Africa to less than 1 indigenous case with a prediction of this goal being achieved by the year 2026. Malaria elimination in South Africa is feasible and economically worthwhile with a guaranteed positive return on investment (ROI). Findings of this study show that through securing funding for the proposed malaria interventions in the endemic areas of South Africa and neighbouring Mozambique, national elimination could be within reach in an 8-year period.

中文翻译：

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南非消除疟疾的投资案例：为加速区域消除疟疾而调动资源的融资模式

疟疾仍然是南非的一个公共卫生问题。虽然该疾病主要局限于九个省中的三个，但大多数本地传播是由于从邻国输入病例而发生的。南非政府重申了其在其境内消灭疟疾的承诺。为支持实现这一目标，本研究通过模拟旨在在 10 年内消除疟疾的不同情景，对南非消除疟疾的成本效益分析进行了分析。开发了一个动态数学传播模型，以估算 2018 年至 2030 年南非消除疟疾的成本和收益。该模型模拟了一系列疟疾干预措施，并估计了它们对 2018 年至 2030 年间在林波波省、普马兰加省和夸祖鲁-纳塔尔省三个流行省份恶性疟原虫疟疾传播的影响。当地金融、经济和流行病学数据用于校准传播模型。基于三个主要模拟情景：照常营业、加速和减少来源，总经济负担估计如下：对于照常营业情景，南非疟疾的总经济负担为 36.9 亿兰特（2.233 亿美元） ) 超过 11 年（2018-2029 年）。对于加速和源头减少情景，疟疾的经济负担估计分别为 48.8 亿兰特（2.955 亿美元）和 63.4 亿兰特（约 3.84 亿美元）。成本和收益以 2020 年年中的价值呈现。如果采用源头减少战略来帮助降低莫桑比克南部的疟疾发病率，则预计所有三个省份都将消除疟疾。这可以通过将南非本地年发病率限制在少于 1 例本土病例并预测到 2026 年实现这一目标来实现。 ）。这项研究的结果表明，通过为南非和邻国莫桑比克的流行地区拟议的疟疾干预措施争取资金，全国消除可能在 8 年内实现。如果采用源头减少战略来帮助降低莫桑比克南部的疟疾发病率，预计所有三个省份都将消除疟疾。这可以通过将南非本地年发病率限制在少于 1 例本土病例并预测到 2026 年实现这一目标来实现。 ）。这项研究的结果表明，通过为南非和邻国莫桑比克的流行地区拟议的疟疾干预措施争取资金，全国消除可能在 8 年内实现。如果采用源头减少战略来帮助降低莫桑比克南部的疟疾发病率，则预计所有三个省份都将消除疟疾。这可以通过将南非的本地年发病率限制在少于 1 例本土病例并预测到 2026 年实现这一目标来实现。 ）。这项研究的结果表明，通过为南非和邻国莫桑比克的流行地区拟议的疟疾干预措施争取资金，全国消除可能在 8 年内实现。这可以通过将南非的本地年发病率限制在少于 1 例本土病例并预测到 2026 年实现这一目标来实现。 ）。这项研究的结果表明，通过为南非和邻国莫桑比克的流行地区拟议的疟疾干预措施争取资金，全国消除可能在 8 年内实现。这可以通过将南非的本地年发病率限制在少于 1 例本土病例并预测到 2026 年实现这一目标来实现。 ）。这项研究的结果表明，通过为南非和邻国莫桑比克的流行地区拟议的疟疾干预措施争取资金，全国消除可能在 8 年内实现。