Summary of Population-based Interventions| Condition | Intervention | Intervention description | Intervention setting | Objective | Target populationa | Cost-effectiveness (US$/DALY) | Cost-effectiveness rangeb (US$/DALY) | Number of DALYs avertedb (hundreds) | Number of deaths avertedb | Quality of cost-effectiveness analysis evidencec |
| Adolescent health and nutrition | School health and nutrition programs | Inclusion of deworming of intestinal worms and schistosomiasis; prompt recognition and treatment of malaria; insecticide-treated bednets; micronutrient supplements; breakfast, snacks, other meals; first-aid kits; referral to youth-friendly clinics; and counseling and psychosocial support | Community, school | Population-oriented medical intervention | School-age children | 37 | — | — | — | 3 |
| Alcohol abuse | Excise tax | 25 to 50 percent increase in the current excise tax rate on alcoholic beverages | Policy level | Instrument of policy | Adolescents and adults | 1,377 | 1,249-1,504 | 0.62 | — | 5 |
| Alcohol abuse | Advertising ban and reduced access to beverage retail | Reduced access to alcoholic beverage retail outlets by reducing the hours of sale or advertising bans on television, radio, and billboards | Policy level | Instrument of policy | Adolescents and adults | 404 | 367-441 | 0.44 | — | 5 |
| Alcohol abuse | Excise tax, advertising ban, with brief advice | 50 percent increase in the current excise tax rate on alcoholic beverages, combined with advice, education sessions, and psychosocial counseling; possible inclusion of random driver breath testing and advertising bans | Policy level | Instrument of policy | Adolescents and adults | 631 | 601-661 | 2.85 | — | 5 |
| Chagas disease | Vector control | Vector control activities including spraying combined with housing improvement, community involvement in surveillance, and strong programs of health education | Community | Control of environmental hazard | All ages | 284 (Latin America and the Caribbean) | — | — | — | 1 (Latin America and the Caribbean) |
| Coronary artery disease | Legislation substituting 2% of trans fat with polyunsaturated fat at US$0.50 per adult | Legislation replacing 2% of dietary trans fat from partial hydrogenation in manufactured foods with polyunsaturated fat, at a cost of US$0.50 per adult, and assuming a 7% reduction in coronary artery disease | Policy level | Instrument of policy | Adults | 48 | — | — | — | 5 |
| Coronary artery disease | Legislation substituting 2% of trans fat with polyunsaturated fat at US$6 per adult | Legislation replacing 2% of dietary trans fat from partial hydrogenation in manufactured foods with polyunsaturated fat, at a cost of US$6 per adult, and assuming a 7-40% reduction in coronary artery disease | Policy level | Instrument of policy | Adults | 838 | 199-1,478 | — | — | 5 |
| Dengue | Vector control | Chemical vector control usinglarvicides and insecticide space sprays (including emephos, permethrin, methoprene, pyriproxyfen, and Bacillus thuringiensis israelensis) to protect drinking water, or environmental vector control, such as removal of standing water | Community or district hospital | Control of environmental hazard | All ages | 2,566 | 1,992-3,139 | — | — | 2 |
| Dengue | Immunization | Dengue immunization (a vaccine is currently undergoing clinical trials in Southeast Asia) | Community clinic or district hospital | Population-oriented medical intervention | Children | 1,440 | — | — | — | 2 |
| Diabetes, ischemic heart disease, and stroke | Legislation with public education to reduce salt content | Legislated reduction in salt content of manufactured foods and an accompanying public education campaign | Policy level | Instrument of policy | All ages | 1,937 | — | 18.73 | — | 5 |
| Diabetes, ischemic heart disease, and stroke | Media campaign to reduce saturated fat | Media campaign to reduce saturated fat content in manufactured foods and replace part of the saturated fat with polyunsaturated fat | Policy
level | Instrument of policy | All ages | 2,617 | — | 13.86 | — | 5 |
| Diarrheal disease | Breastfeeding promotion | Promotion of exclusive breast-feeding (recommended for six months) to new mothers, in which no other food or drink, including water, is permitted, except for supplements of vitamins and minerals and necessary medicines | Community, clinic, or district hospital | Personal behavior change | Adult women | 930 | — | 0.43 | 1.33 | 5 |
| Diarrheal disease | Cholera or rotavirus immunization | Immunization for endemic cholera with live oral vaccine or rotavirus immunization with rhesus-human rotavirus reassortant-tetravalent vaccine(currently under development) in populations at risk of an outbreak | Clinic | Population-oriented medical intervention | Children | 2,712 | 2,478-2,945 | 0.62 | 1.98 | 5 |
| Diarrheal disease | Improved water and sanitation at current coverage of amenities and other interventions | Improved water supply and excreta disposal where established infrastructure currently exists, in urban or rural settings for at least five years | Community | Control of environmental hazards | All ages | 4,185 | 1,974-6,396 | 3.52 | 315.30 | 5 |
| Diarrheal disease | Hand pump, stand post, or house connection where clean water supply is limited | Installation of hand water pump, stand post, or house connection where clean water supply is limited and associated infra-structure currently do not exist | Community | Control of environmental hazards | All ages | 159 | — | — | — | 1 |
| Diarrheal disease | Water sector regulation with advocacy where clean water supply is limited | Surveillance of drinking water quality and quality of service by the water supply utility in terms of coverage, quantity, continuity, control of sanitary hazards, and cost, as well as advocacy of lower connection charges | Policy level, community | Instrument of policy, control of environmental hazards | All ages | 47 | — | — | — | 1 |
| Diarrheal disease | Construction and promotion of basic sanitation where facilities are limited | Construction of low-cost excreta disposal facilities such as house-hold pit latrines, ventilation-improved latrines, or pour-flush toilets, combined with public promotion of sanitation and hygiene | Policy level, community | Instrument of policy, control of environmental hazards | All ages | 141 | 11-270 | — | — | 1 |
| Down syndrome | Prenatal screening with option of pregnancy termination | Prenatal genetic screening program, incorporating maternal serum triple screening of all pregnant women, for trisomy of chromosome 21, to allow parents to determine whether to continue with an affected pregnancy | Clinic, district hospital | Population-oriented medical intervention | Pregnant women | 15 | — | — | — | 5 |
| Emergency medical care | Training volunteer paramedics with lay first responders | Identification and training of community member first responders and paramedics to act in health emergencies, recognize life-or limb-threatening situations, transport patients, and provide basic first aid | Policy level | Instrument of policy | All ages | 6 | — | 18.42 | 74.00 | 5 |
| Emergency medical care | Staffed community ambulance | Introduction or promotion of training programs for emergency responders and ambulance drivers in urban or rural settings for countries that lack ambulances and training programs | Policy level | Instrument of policy | All ages | 120 | 60-179 | 34.84 | 140.00 | 5 |
| Haemophilus influenzae type B(Hib) | Vaccine containing Hib | Hib vaccination (three or four doses), given concurrently with diphtheria-pertussis-tetanus | Clinic | Population-oriented medical intervention | Infants and children | 733d | — | 29.25 | 113.83 | 5 |
| Hib, and hepatitis B, diphtheria, pertussis, and tetanus | Pentavalent vaccine | Hib vaccination (three or four doses) and hepatitis B (three or four doses) given concurrently with diphtheria-pertussis-tetanus vaccine | Clinic | Population-oriented medical intervention | Infants and children | 296d | — | — | — | 5 |
| Hepatitis B | Hepatitis B vaccination | Hepatitis B (three or four doses) given through intramuscular injection | Clinic | Population-oriented medical intervention | Infants and children | 23,520d | — | — | — | 5 |
| HIV/AIDS | Condom promotion and distribution | Targeted distribution and placement of condoms in locations such as bars or brothels; distribution linked to voluntary counseling and testing and sexually transmitted infection care to ensure universal access; information, education, and communication, including education through literature, classroom, and clinical settings and radio, newspapers, and television | Community or Community, clinic | Personal behavior change | Adolescents and adults | 82 (Sub-Saharan Africa) | 52-112 (Sub-Saharan Africa) | — | — | 1 (Sub-Saharan Africa) |
| HIV/AIDS | Blood and needle safety | Screening of all blood for transfusions; sterilization for all injections; harm reduction for injecting drug users, including needle exchange and drug substitution programs | All levels, including community clinics to referral hospitals | Population-oriented medical intervention | All ages | 84 (Sub-Saharan Africa) | 7-161 (Sub-Saharan Africa) | — | — | 2 (Sub-Saharan Africa) |
| HIV/AIDS | Voluntary counseling and testing | Routine and voluntary confidential HIV counseling and testing | Clinic | Population-oriented medical intervention | Adults | 47 | 10-85 | — | — | 2 |
| HIV/AIDS | Peer and education programs for high-risk groups | Targeting community members(for example, students or commercial sex workers) to disseminate information and teach specific skills | Community | Personal behavior change | Adolescents and adults | 37 | 6-68 | — | — | 2 |
| Lymphatic filariasis | Annual mass drug administration | Two annual, single-dose, two-drug regimens are recommended: ivermectin plus albendazole in African countries that are coendemic for onchocerciasis, and diethylcarbamazine plus albendazole for all other endemic countries | Clinic, community | Population-oriented medical intervention | All ages | 15 (South Asia) | 4-27 (South Asia) | — | — | 4 (South Asia) |
| Lymphatic filiariasis | Diethyl carbamazine salt | Fortification of salt with diethyl carbamazine | Policy level | Instrument of policy | All ages | 22 (South Asia) | 1-43 (South Asia) | — | — | 4 (South Asia) |
| Lymphatic filariasis | Vector control | Integrated vector control to reduce overall prevalence of microfilaria parasites, such as polystyrene beads in vector(mosquito) breeding habitats | Policy level | Instrument of policy | All ages | 160 (South Asia) | 43-277 (South Asia) | — | — | 4 (South Asia) |
| Malaria | Insecticide-treated bednets | Impregnation of bednets with deltamethrin, one treatment of permethrin, or two treatments of permethrin, with the bednets either purchased or subsidized | Household | Control of environmental hazards | All ages | 11 (Sub-Saharan Africa) | 5-17 (Sub-Saharan Africa) | 376.00 (Sub-Saharan Africa) | 1,429.60 (Sub-Saharan Africa) | 5 (Sub-Saharan Africa) |
| Malaria | Residual house-hold spraying | One or two doses of malathion, DDT, deltamethrin, or lambda-cyhalothrin applied to household surfaces | Household | Control of environmental hazards | All ages | 17 (Sub-Saharan Africa) | 9-24 (Sub-Saharan Africa) | 376.00 (Sub-Saharan Africa) | 1,429.60 (Sub-Saharan Africa) | 5 (Sub-Saharan Africa) |
| Measles | Second opportunity vaccination in a fixed facility | Second opportunity to receive a dose of measles vaccine (either through routine or supplemental immunization activities) at a fixed facility | Clinic | Population-oriented medical intervention | Infants and children | 4 | — | — | — | 5 |
| Meningitis | Neisseria meningitidis vaccine | Neisseria meningitidis vaccine for serogroups A, C, Y, Wi35 only; unconjugated polysaccharides given subcutaneously; one dose with repeat three to five years later for those at high risk | Clinic | Population-oriented medical intervention | Children | 12,632 (Sub-Saharan Africa) | — | — | — | 5 (Sub-Saharan Africa) |
| Problems requiring surgery | Surgical ward or services in district hospital or community clinic | Surgical ward in a district hospital or community clinic to provide care for a wide range of conditions, such as trauma, childbirth, and abdominal conditions | District hospital, clinic | Instrument of policy | All ages | 136 | 54-217 | — | — | 5 |
| Onchocerciasis | Ivermectin | Annual dose of ivermectin | Clinic, community | Population-oriented medical intervention | Adults over 40 | 37 | — | — | — | 3 |
| Soil-transmitted helminthic infections | Albendazole | Annual albendazole anti-helminthic drug treatment to reduce morbidity through the deworming of Ascaris, Trichuris, and hookworm in school-age children | Community, school | Population-oriented medical intervention | School-age children | 3 | — | 127.76 | 1.98 | 5 |
| Tetanus | Tetanus toxoid vaccination, mix of strategies | Tetanus toxoid vaccination via a mix of strategies depending on local needs, including fixed facilities, immunization campaigns, mobile delivery, and community outreach | Clinic, community | Population-oriented medical intervention | Infants and children | 1,411 | — | — | — | 5 |
| Tobacco addiction | Taxation causing 33% price increase | A 33 percent price increase due to tobacco taxes to discourage tobacco use, prevent initiation(and subsequent addiction) among youths, increase the likelihood of cessation among current users, reduce relapse among former users, and reduce consumption among continuing users | Policy level | Instrument of policy | Adolescents and adults | 22 | — | 37.27 | 1,905.99 | 5 |
| Tobacco addiction | Nonprice interventions | Advertising bans on television, radio, and billboards; health information and advertising in the form of health warning labels on tobacco products; interventions to reduce tobacco supply, such as smuggling control; restrictions on smoking | Policy level | Instrument of policy | Adolescents and adults | 353 | — | — | — | 5 |
| Traffic accidents | Increased speeding penalties, enforcement, media campaigns, and speed bumps | Minimizing exposure to high-riskscenarios by installation of speed bumps at hazardous junctions, increased penalties for speeding, and other effective road-safety regulations combined with media coverage and better enforcement of legislation | Policy level | Instrument of policy | Adults | 21 | 3-38 | 0.67 | 197.16 | 5 |
| Traffic accidents | Enforcement of seatbelt laws, promotion of child restraints and random driver breath testing | Mandatory seat belt and child-restraint laws, enforcement of drunk-driving laws, and random breath testing of drivers | Policy level | Instrument of policy | Adults | 2,449 | 999-3,899 | 0.32 | 93.87 | 5 |
| Tuberculosis(endemic) | BCG vaccine | Live attenuated vaccine, BCG; recommended at birth or at first contact with health services in areas of high incidence | Clinic or district hospital | Primary prevention Population-oriented medical intervention | Children | 68 | 55-82 | — | — | 5 |
| Tuberculosis, diphtheria, pertussis, tetanus, polio, measles | Traditional Expanded Program on Immunization(EPI) | Scaling up of EPI; a fixed increment of coverage added for each year 2002-11 to reach 90 percent; coverage increases assumed to result from switching to more effective and intensive implementation strategies rather than additional infrastructure investments | Community | Population-oriented medical intervention | Infants and children | 7 | — | — | — | 5 |
| Undernutrition and malnutrition | Sustained child health and nutrition program | Possible inclusion of prenatal care, women's health and nutrition, breastfeeding promotion and counseling, complementary feeding, growth monitoring and promotion, micronutrient supplementation, micronutrient fortification, supplementary feeding using local supplies, oral rehydration, and immunization and deworming; actual mix depends on local capabilities and conditions | Community, clinic | Population-oriented medical intervention | Children under five | 225 | — | — | — | 3 |
| Underweight children | Child survival program with nutrition component | Community-based nutrition programs to prevent growth faltering, control morbidity, and improve survival by promoting breastfeeding, providing education and counseling on optimal child feeding, preventing diarrheal disease, and monitoring growth | Community | Population-oriented medical intervention | Children under five | 42 | — | — | — | 2 |
