ArticleBMJ global health2024
Ten-year health impact, economic impact and return on investment of the South African molecular diagnostics programme for HIV, tuberculosis and SARS-CoV-2.
Article in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Closing gaps through innovation in the tuberculosis pathology value chain.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Review
- Patterns of Infectious Disease Identified in Clinical Autopsy at a South African Tertiary Care Setting: A 10-Year Retrospective Study.Diseases (Basel, Switzerland) · 2026Article
- Transforming Hematology Care in Africa: Strategies for Enhanced Diagnosis and Treatment.Health science reports · 2026Article
- A retrospective analysis of tuberculosis notification trends and spatial distribution in South Africa, 2005-2012.Discover public health · 2026Article
- Xpert MTB/RIF Ultra 'trace': considerations for diagnostics.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2025Article
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12 authors.
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Abstract
introductionTo ensure there is adequate investment into diagnostics, an understanding of the magnitude of impact and return on investment is necessary. We, therefore, sought to understand the health and economic impacts of the molecular diagnostic programme in South Africa, to deepen the understanding of the broad value of diagnostics and guide future healthcare investments.
methodsWe calculated the 10-year (where data were available) total cost and disability-adjusted life-years (DALYs) averted associated with molecular testing for tuberculosis diagnosis (2013-2022), HIV viral load monitoring (2013-2022), early infant diagnosis of HIV infection (2013-2022) and SARS-CoV-2 testing (2020-2022), based on the actual number of molecular tests conducted in South Africa for the respective time periods. We then calculated the economic value associated with those health gains and subsequent return on investment.
resultsSince the inception of the molecular diagnostics programme in South Africa, approximately 4.3 million DALYs (uncertainty range (UR): 2.8-5.8 million) have been averted as a direct consequence of this programme. This has generated an estimated US$28.3 billion in economic value due to these health gains (UR$18.4-UR$38.7 billion). The return on investment varied by specific diagnostic test (20.3 (UR 15.2-25.4) for tuberculosis, 7.7 (UR 1.6-13.9) for HIV viral load testing, 63.0 (UR 63.0-65.5) for early infant diagnosis of HIV and 2.5 (UR 0.7-4.6) for SARS-CoV-2), for an average of 13.9 (UR 9.0-18.9) for the entire molecular diagnostics programme or US$13.9 of value for each UR$1 invested.
conclusionsThe molecular diagnostics programme in South Africa generated a significant amount of health gains and economic value associated with these health gains. The return on investment rivals other high-impact public health interventions such as childhood vaccination. The molecular diagnostics programme in South Africa is highly impactful and will continue to be an excellent investment in South African public health expenditure.
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