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Item refines Preprint · not peer-reviewed Added

Health opportunity cost estimates updated for 92 low- and middle-income countries

The marginal cost per DALY averted ranges from about $54 to $18,547 across 92 low- and middle-income countries.

The study re-estimates the marginal cost per DALY averted from government health expenditure in 92 low- and middle-income countries. Elasticities from Ochalek et al. (2018) were applied to recent mortality, morbidity, population and expenditure data, not re-estimated. Estimates ranged from about $54 to $18,547 per DALY averted, higher than Ochalek et al. (2018) in 68% of countries. Raising government health spending to a tiered minimum of 10% or 15% would avert 145 million DALYs, costing $392 billion. Reallocating $11.2 billion of on-budget development assistance by country-specific opportunity cost would avert 75.3 million DALYs, against 45.3 million now. Allocating the $25.7 billion off-budget, NGO and philanthropic envelope would avert 66.1 million more, from a baseline of none.

Why it is interesting: Earlier versions of these estimates informed priority setting in several countries and international policy discussions. The reallocation scenarios put a figure on what current donor allocation may forgo.

Source
medRxiv, 15 October 2026
Paper
Updated Health Opportunity Cost Estimates for 92 Low- and Middle-Income Countries: Implications for Global Health Financing and Donor Allocation
Authors
Ochalek JM
DOI
10.64898/2026.03.31.26349880
Type
Preprint
Design
Economic modelling study applying previously estimated expenditure–outcome elasticities (Ochalek et al. 2018) to recent mortality, morbidity, population and government health expenditure data for 92 low- and middle-income countries, with two allocation scenarios
Verdict
Refines prior evidence
Driver
Health systems and access
Driver
Revisions and new sources
Driver
Value in health

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