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Characterising the costs of the Global Polio Laboratory Network: a survey-based analysis
  1. Radboud J Duintjer Tebbens1,
  2. Ousmane M Diop2,
  3. Mark A Pallansch3,
  4. M Steven Oberste3,
  5. Kimberly M Thompson1
  1. 1 Kid Risk, Columbus, Ohio, USA
  2. 2 Global Polio Eradication Initiative, World Health Organization, Geneva, Switzerland
  3. 3 Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Dr Kimberly M Thompson; kimt{at}


Objective To characterise the costs, including for environmental surveillance (ES), of the Global Polio Laboratory Network (GPLN) that provides laboratory support to the Global Polio Eradication Initiative (GPEI).

Design and participants We conducted a survey of the network across 92 countries of the 146 GPLN laboratories plus three non-GPLN laboratories that concentrate environmental samples to collect information about their activities, characteristics and costs during 2016. We estimate the total costs using regression of reported responses and complementing the findings with GPEI data.

Results We received responses from 132 (89%) of the 149 laboratories, with variable response rates for individual questions. We estimate that processing samples of patients with acute flaccid paralysis leads to total costs of approximately $28 million per year (2016 US$) based on extrapolation from reported costs of $16 million, of which 61% were supported by internal (national) funds. Fifty-nine (45%) of the 132 responding laboratories reported supporting ES and we estimate an additional $5.3 million of recurring costs for ES activities performed by the laboratories. The reported costs do not include an estimated additional $10 million of annual global and regional costs to coordinate and support the GPLN. On average, the staff supported by funding for polio in the responding laboratories spent 30% of their time on non-polio activities. We estimate total costs for laboratory support of approximately $43 million (note that this estimate does not include any field or other non-laboratory costs of polio surveillance).

Conclusions Although countries contribute significantly to the GPLN financing, many laboratories currently depend on GPEI funds, and these laboratories also support the laboratory component of surveillance activities for other diseases. Sustaining critical global surveillance for polioviruses and transitioning support for other disease programmes will require continued significant funding after polio certification.

  • poliovirus
  • surveillance
  • eradication
  • cost
  • global health

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  • Contributors All authors (RJDT, OMD, MAP, MSO, KMT) contributed to the study design, survey instrument development, interpretation of data, manuscript writing and revisions. The first author (RJDT) performed the data analysis, the last author (KMT) coded and administered the survey instrument in SurveyMonkey, the second author (OMD) contacted the laboratories, and the first and second authors (RJDT, OMD) recruited participants and followed up with respondents on any questions.

  • Funding This publication was supported by cooperative agreement number 5NU2RGH001913-02-00 funded by the Centers for Disease Control and Prevention.

  • Disclaimer The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors will provide the technical appendix provided to the reviewers.

  • Correction notice This article has been corrected since it published Online First. The PDF of the supplementary file was corrupt.

  • Patient consent for publication Not required.

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