August 1, 2015
INFECTIOUS diseases are a leading cause of death worldwide, accounting for a quarter to a third of all mortality.1 In most industrialised countries, infectious disease ranks after cancer and heart disease as a leading cause of mortality. Despite developments in pharmaceuticals, infectious disease rates are rising due to changes in human behaviour, larger and denser cities, increased trade and travel, the inappropriate use of antibiotic drugs, and the emergence of new and resurgent pathogens (Dobson and Carper, 1996). Infectious disease outbreaks can easily cross borders to threaten economic and regional stability, as has been demonstrated by the HIV, H1N1, H5N1, and SARS epidemics and pandemics (Dixon et al., 2001, 2010; Fan, 2003; Chou et al., 2004; Hai et al., 2004; Lee and McKibbin, 2004; Jonung and Roeger, 2006; Keogh-Brown et al., 2010; Verikios et al., 2012). The threat to stability derives from a number of features of infectious disease outbreaks. One, the nature of emerging diseases is that, by definition, they are not commonly encountered by physicians and are thus capable of generating widespread infection and mortality prior to identification of the aetiologic agent (e.g. HIV/AIDS). Two, drug development and approval timeline lags the emergence of these diseases such that the initial infection can result in significant mortality. Three, the constant adaptation of microbes, along with their ability to evolve and become resistant to antibacterial and antiviral agents, ensures that infectious diseases will continue to be an ever-present and ever-changing threat. Our interest is to assess the threats to economic and regional stability from infectious disease outbreaks; we focus on pandemic influenza as it is a regularly recurring form of infectious disease in history. We assess these risks by modelling the effects of a range of influenza pandemic scenarios by linking epidemiological and economic models. The nature of the scenarios covers a broad spectrum of possible pandemic events. As such, our results provide policymakers with information on the orders of magnitude and qualitative effects across regions of possible future pandemic influenza outbreaks.