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| Laxminarayan, Ramanan. |
| In the past, malaria control efforts in sub-Saharan Africa have relied on a combination of vector control and effective treatment using chloroquine. With increasing resistance to chloroquine, attention has now turned to alternative treatment strategies to replace this failing drug. Although there are strong theoretical arguments in favor of switching to more expensive artemisinin-based combination treatments (ACTs), the validity of these arguments in the face of financial constraints has not been previously analyzed. In this paper, we use a Bioeconomic model of malaria transmission and evolution of drug resistance to examine questions of optimal treatment strategy and coverage when drug resistance places an additional constraint on choices available to the... |
| Tipo: Working or Discussion Paper |
Palavras-chave: Malaria; Mathematical models; Drug resistance; Bioeconomics; Health Economics and Policy; I10; I19; C61. |
| Ano: 2003 |
URL: http://purl.umn.edu/10699 |
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| Laxminarayan, Ramanan. |
| The increasing resistance of harmful biological organisms (bacteria, parasites, and pests) to selection pressure from the widespread use of control agents such as antibiotics, antimalarials, and pesticides is a serious problem in both medicine and agriculture. Modeling resistance-or, conversely, the effectiveness of these control agents as a biological resource-yields insights into how these agents should be optimally managed to maximize their economic benefit to society. This paper uses a model of evolution of bacterial resistance to antibiotics-in which resistance places an evolutionary disadvantage on the resistant organism-to develop a simple sequential algorithm of optimal antibiotic use. Although the solution to this problem follows the... |
| Tipo: Working or Discussion Paper |
Palavras-chave: Antibiotic resistance; Natural resource; Optimization; Health Economics and Policy; I0; Q0. |
| Ano: 2001 |
URL: http://purl.umn.edu/10479 |
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| Laxminarayan, Ramanan; Simpson, R. David. |
| When the application of pesticides places selective evolutionary pressure on pest populations, it can be useful to plant refuge areas-crop areas intended to encourage the breeding of pests that are susceptible to the pesticide. Renewed interest in refuge areas has arisen with recent advances in biotechnology and genetically modified (GM) crops. In this paper, we use a simple model of the evolution of pest resistance to characterize the socially optimal refuge strategy for managing pest resistance. We demonstrate some interesting analogies with other models of renewable resource management, such as those of fisheries. Among the analogous results are findings that maintaining what we might call "maximal sustainable susceptibility" is typically not... |
| Tipo: Working or Discussion Paper |
Palavras-chave: Pest resistance; Biotechnology; Optimization; Research and Development/Tech Change/Emerging Technologies; Q1; Q2. |
| Ano: 2000 |
URL: http://purl.umn.edu/10914 |
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| Laxminarayan, Ramanan. |
| Living in malaria-endemic regions places an economic burden on households even if they do not actually suffer an episode of malaria. Households living with endemic malaria are less likely to have access to economic opportunities and may have to modify agricultural practices and other household behavior to adapt to their disease environment. Data from Vietnam demonstrate that reductions in malaria incidence through government-financed malaria control programs can contribute to higher household income for all households living in endemic areas. Empirically, a 10% decrease in malaria cases at the national level translates to a roughly US $30 million annual economic benefit in the form of improved living standards. |
| Tipo: Working or Discussion Paper |
Palavras-chave: Malaria; Living standards; Disease; Health Economics and Policy; D1; O1; I0. |
| Ano: 2003 |
URL: http://purl.umn.edu/10633 |
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| Laxminarayan, Ramanan; Brown, Gardner M., Jr.. |
| In recent years bacteria have become increasingly resistant to antibiotics, leading to a decline in the effectiveness of antibiotics in treating infectious disease. This paper uses a framework based on an epidemiological model of infection in which antibiotic effectiveness is treated as a nonrenewable resource. In the model presented, bacterial resistance (the converse of effectiveness) develops as a result of selective pressure on nonresistant strains due to antibiotic use. When two antibiotics are available, the optimal proportion and timing of their use depends precisely on the difference between the rates at which bacterial resistance to each antibiotic evolves and on the differences in their pharmaceutical costs. Standard numerical techniques are used... |
| Tipo: Working or Discussion Paper |
Palavras-chave: Antibiotics; Disease; Externality; Livestock Production/Industries; Q3; I1. |
| Ano: 2000 |
URL: http://purl.umn.edu/10619 |
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