The Economics of Planning and Preparing for Bioterrorism

10. Summary

In this chapter, I have demonstrated that it is possible to calculate the optimal annual amount that should be spent on a defined intervention to prevent or reduce the impact of a bioterrorist attack or other catastrophic infectious disease event. Such calculations, however, are not trivial and require a great deal of information. The information includes the epidemiology of the disease (e.g., who gets ill, what happens to them), the cost of such impacts, the potential effectiveness of proposed interventions, and an understanding of the annual probability of the event actually occurring. There are a great number of uncertainties associated with each of these inputs, and the impact of such uncertainties must be explored through systematic sensitivity analyses. One of the goals of such sensitivity analyses should be to identify the 2–3 most influential inputs. These 2–3 influential inputs then represent potential “policy levers” that policy makers can focus interventions. Finally, it must be appreciated that calculating the optimal annual amount to be spent on an intervention is not the complete set of decision-making points. There are many other factors influencing the choice of intervention. However, because calculating the optimal amount to be spent on a given intervention combines many different variables into a single estimate (the optimal amount), the calculated amount provides valuable information by which to start the decision-making process.