Perspectives of economic costs of disease outbreaks to health systems
George Nyadimo Agot, Marshal Mutinda Mweu
Corresponding author: George Nyadimo Agot, Department of Public and Global Health, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya 
Received: 12 Mar 2026 - Accepted: 20 Mar 2026 - Published: 07 May 2026
Domain: Public health
Keywords: Perspectives, economic costs, disease outbreaks, zoonotic diseases, health systems
Funding: This work received no specific grant from any funding agency in the public, commercial, or non-profit sectors.
©George Nyadimo Agot et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: George Nyadimo Agot et al. Perspectives of economic costs of disease outbreaks to health systems. Pan African Medical Journal. 2026;54:4. [doi: 10.11604/pamj.2026.54.4.52132]
Available online at: https://www.panafrican-med-journal.com//content/article/54/4/full
Perspectives of economic costs of disease outbreaks to health systems
&Corresponding author
Disease outbreaks are random public health phenomena attributed to known or idiopathic human, animal, and animal-based factors; a realm referred to as the One Health concept; a new global public health order for control and prevention of epidemics, endemics, and pandemics. These are diseases of viral, prion, bacterial, fungal, and parasitic origin, transmitted between vertebrate animals and humans and vice versa. Emergence and re-emergence of zoonotic diseases such as rabies, Ebola, COVID-19, monkeypox, avian influenza, anthrax, brucellosis, leptospirosis, and lyme disease continue to affect populations across the world, pointing to unexpected Budget Impacts of the affected countries.
Notably, outbreaks of such diseases undoubtedly exert an enormous economic burden on the fiscal national resource envelope, attributed to substantial economic costs of outbreak surveillance and related public health interventions [1-4]. Even though some of the infectious diseases have been eradicated or nearly wiped out from nature due to strategic medical and public health interventions, persistence, emergence, and re-emergence of new and old infectious diseases underscores estimation of the economic costs of disease outbreaks to health systems [2]. Strategies aimed at controlling and preventing outbreaks of zoonotic diseases comprise public health, medical interventions, and behaviour change interventions [1,2,5]. Cost drivers for medical interventions consist of diagnosis, treatment regimens, and personnel due to surging human capital and productivity loss [1,2,5]. Additionally, the cost drivers for public health interventions comprise surveillance, individual and environmental hygiene, human and animal vaccinations, whilst behaviour change interventions include mass media campaigns, Information, Education and Communication (IEC) materials [1,2,5].
The cost drivers, consisting of direct and overhead (shared) costs of the aforementioned interventions, are often gathered through the ingredient or activity-based costing (ABC) approaches from the health providers' economic perspective and categorized as recurrent and capital costs [1]. The process of gathering the economic costs of the above-named interventions constitutes identification, measurement, valuation, and comparison of costs of alternatives being considered, including the status quo [1]. Recurrent (variable) costs comprise the cost of routine personnel, personnel capacity surge, personnel productivity loss, as well as pharmaceutical, non-pharmaceutical, medical, non-medical, surgical, and non-surgical supplies, as well as overhead costs [1]. Capital (fixed) costs, on the other hand, constitute diagnostic and imaging equipment, machinery, health and medical care infrastructure such as buildings, ambulances, and internet, among others [1]. Further, capital costs are considered for differential-time discounting, whilst statistical and/or sensitivity analysis is conducted to ascertain the robustness of the costing exercise findings because of possible uncertainties arising from sample size determination and data collection methods [1,6-9].
Finally, perspectives of economic costs of disease outbreaks to health systems should always be reported as per the CHEERS (Checklist for Consolidated Health Economic Evaluation Reporting Standards) guidelines [10]. Estimating economic costs of zoonotic disease outbreaks from a health systems perspective is of great global significance in understanding their impact on public health resource envelop, as well as informing and developing public health policies with a view to formulating system-specific mitigation preparedness [1,2].
The authors declare no competing interests.
- Drummond MF, MJ Sculpher, K Claxton, GL Stoddart. Methods for the economic evaluation of health care programmes. Oxford university press. 2015.
- Fonkwo PN. Pricing infectious disease: The economic and health implications of infectious diseases. EMBO reports. 2008 Jul;9 Suppl 1(Suppl 1):S13-7. PubMed | Google Scholar
- Wang L, Crameri G. Emerging zoonotic viral diseases. Rev Sci Tech. 2014 Aug;33(2):569-81. PubMed | Google Scholar
- Slingenbergh JI, Gilbert M, de Balogh KI, Wint W. Ecological sources of zoonotic diseases. Revue scientifique et technique-Office international des épizooties. 2004 Aug;23(2):467-84. PubMed | Google Scholar
- Barai MK, Dhar S. COVID-19 pandemic: Inflicted costs and some emerging global issues. Global Business Review. 2024;25(3):p.812-831. Google Scholar
- Walker D, Kumaranayake L. Allowing for differential timing in cost analyses: discounting and annualization. Health policy and planning. 2002 Mar;17(1):112-8. PubMed | Google Scholar
- Sandmann FG, Robotham JV, Deeny SR, Edmunds WJ, Jit M. Estimating the opportunity costs of bed-days. Health economics. 2018 Mar;27(3):592-605 Epub 2017 Nov 6. PubMed | Google Scholar
- Conteh L, Walker D. Cost and unit cost calculations using step-down accounting. Health policy and planning. 2004 Mar;19(2):127-35. PubMed | Google Scholar
- Agot GN, Wang'ombe JK, Mweu MM. Cost analysis of outpatient services for major external structural birth defects: an ingredient approach in selected hospitals in Kiambu County, Kenya. Pan Afr Med J. 2024 Jul 25:48:137. PubMed | Google Scholar
- Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D et al. Consolidated health economic evaluation reporting standards (CHEERS)-explanation and elaboration: a report of the ISPOR health economic evaluation publication guidelines good reporting practices task force. Value in health. 2013 Mar-Apr;16(2):231-50. PubMed | Google Scholar




