From 2000 to 2022, pandemic pathogens such as SARS-CoV-2, the virus that causes COVID-19, imposed the largest historical and projected emerging infectious disease (EID) burdens around the world, while dengue and cholera were the most burdensome non-pandemic illnesses, suggests a new analysis in BMJ Global Health.
By region, the Americas and Africa shouldered the largest per-capita burdens, and the Western Pacific faced the smallest.
Led by Harvard researchers, the study team developed a method for measuring and ranking health and economic disease burdens and applied it to 15 high-priority EIDs in 223 countries and territories historically (2000 to 2022) and prospectively (2025 to 2034).
Health burdens consisted of disability-adjusted life-year losses, converted into monetary values using the value of a statistical life-year. Economic burdens consisted of direct and indirect costs during acute illness for hospitalized patients.
“While many studies have reported the health burdens of individual diseases, … their varying methodologies make disease comparisons difficult,” the researchers wrote.
Disease burdens key to R&D prioritization
COVID-19 had the largest weighted full burden globally ($63.3 trillion) and across all world regions except Africa, where cholera posed a greater burden.
R&D [research and development] priority-setting, including MCM [medical countermeasures] development, depends on multiple criteria, including disease burdens.
The EIDs with the next-largest burdens were cholera, dengue, and pandemic H1N1 influenza, whose full weighted costs were $12.2 trillion, $8.0 trillion, and $4.4 trillion, respectively.
Significantly smaller full burdens were West Nile virus, at $18.8 billion, and Ebola, at a weighted full burden of $93.2 billion. All other EIDs had weighted full burdens at less than $8 billion.
In the United States, pandemic H1N1 made up the second-highest full burden ($235.1 billion), followed by West Nile ($18.2 billion).
“R&D [research and development] priority-setting, including MCM [medical countermeasures] development, depends on multiple criteria, including disease burdens,” the authors concluded. “Our full burden quantification methods and results, along with other such criteria, can inform priority-setting.”