If the tobacco and the salt interventions are implemented jointly, the authors estimate that over the entire 23 countries, 13.8 million deaths could be averted, at a cost of less than US$0.40 per person a year in low-income and lower middle-income countries, and US$0.50–1.00 per person a year in upper middle-income countries (as of 2005).
In terms of absolute population numbers, the biggest gains are expected in the countries with the largest population sizes, that is, mainly China and India. In terms of mortality reductions expressed as deaths averted per 100,000 population, the biggest gains are in the high CVD countries in Eastern Europe (Russian Federation and Ukraine). For Bangladesh, India, and Pakistan, the deaths expected to be averted are in a range of about 50–70 per 100,000 of the relevant population (aged 30 or more).
Neglected low-cost opportunities
World Bank (2006) identifies a limited set of what it calls “neglected low-cost opportunities” for the South Asian region to address CVD (Table A3.1, Appendix 3). At the population level this is again first of all tobacco taxation, leading to an increase in the price of cigarettes by 33 percent, but also non-price interventions of the kind proposed by Asaria et al.
Beyond tobacco control measures and salt regulations, the cost-effectiveness evidence appears to be comparatively scarce in low- and middle-income countries, and there are hardly any studies directly from South Asia. The relative lack of CEA evidence hinges on the lack or absence of effectiveness studies for many types of interventions in a developing-country context.
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