Abstract
BACKGROUND: As of 3 March 2023, Madagascar had reported 1,422 deaths from COVID-19. Up to now, there hasn't been a study to estimate the Total Present Value of Human Life lost (TPVHLMADAGASCAR) , productivity losses, and potential productivity losses averted through COVID-19 vaccination for use in advocacy. The study reported in this paper aimed to fill these information gaps. METHODS: The Human Capital Model (HCM) was used to estimate the TPVHLMADAGASCAR , which is the sum of the discounted value of human life losses among individuals in seven different age groups. The Present Value of Human Life for each age group (PVHLi) was calculated by multiplying the discount factor, the undiscounted years of life, the non-health gross domestic product (GDP) per capita, and the number of COVID-19 deaths in that age group. To test the robustness of the results, the HCM was rerun five times, assuming (i) a 5% discount rate, (ii) a 10% discount rate, (iii) Africa's highest average life expectancy at birth of 78.76 years, (iv) the world's highest life expectancy of 88.17 years, (v) projected excess COVID-19 mortality of 11,418.66 deaths as of 3 March 2023 in Madagascar, and assuming different levels of vaccine coverage: 100%, 70%, 60.93%, and 8.266%. RESULTS: The 1,422 human lives lost due to COVID-19 had a TPVHLMADAGASCAR of Int$ 46,331,412; and an average of Int$ 32,582 per human life. Re-estimation of the HCM, using (i) discount rates of 5% and 10% reduced TPVHLMADAGASCAR by 23% and 53%, respectively; (ii) average life expectancies of 78.76 years and 88.17 years increased TPVHLMADAGASCAR by 23.7% and 39.5%, respectively; (iii) projected excess COVID-19 mortality of 11,418.66 augmented TPVHLMADAGASCAR by 703%. Furthermore, it is estimated that vaccinating 70% of the target population could potentially save the country Int$ 1.1 billion, equivalent to 1.94% of the GDP. CONCLUSIONS: The COVID-19 pandemic has resulted in significant health and productivity losses for Madagascar. Optimizing COVID-19 vaccination coverage for the target population could substantially reduce these losses.