To ensure there is adequate investment into diagnostics, an understanding of the magnitude of impact and return on investment is necessary. We therefore sought to understand the health and economic impacts of the molecular diagnostic programme in South Africa, to deepen the under-standing on the broad value of diagnostics and guide future healthcare investments. We calcu-lated the 10-year (where data were available) total cost and DALYs averted associated with molecular diagnosis of molecular TB testing (2013-2022), HIV viral load monitoring (2013-2022), early infant diagnosis of HIV infection (2013-2022), and SARS-CoV-2 testing (2020-2022). We then calculated the economic value associated with those health gains and subsequent return on investment. Since the inception of the molecular diagnostics programme in South Africa, 3,035,782 DALYs have been averted as a direct consequence of this pro-gramme. This has generated an estimated $20.5 billion in economic value due to these health gains. The return on investment varied by specific diagnostic test (19.0 for tuberculosis, 1.4 for HIV viral load testing, 64.8 for early infant diagnosis of HIV, and 2.5 for SARS-CoV-2), for an average of 9.9 for the entire molecular diagnostics programme between 2013 and 2022- or $9.9 of value for each $1 invested. The molecular diagnostics programme in South Africa gen-erated a significant amount of health gains and economic value associated with these health gains, and the return-on-investment rivals other high-impact public health interventions such as childhood vaccination. Consequently, the molecular diagnostics programme in South Africa is highly impactful, and will continue to be an excellent investment of South African public health expenditure.

中文翻译：

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南非艾滋病毒、结核病和 SARS-CoV-2 分子诊断计划的 10 年健康影响、经济影响和投资回报

为了确保对诊断有足够的投资，有必要了解影响的程度和投资回报。因此，我们试图了解南非分子诊断计划对健康和经济的影响，加深对诊断广泛价值的理解并指导未来的医疗保健投资。我们计算了与分子结核病检测的分子诊断（2013-2022）、HIV病毒载量监测（2013-2022）、婴儿艾滋病毒感染的早期诊断（2013-2022）相关的10年（在有数据的情况下）总成本和避免的伤残调整生命年（DALY）。 2013-2022）和 SARS-CoV-2 检测（2020-2022）。然后，我们计算了与这些健康收益相关的经济价值以及随后的投资回报。自南非启动分子诊断计划以来，由于该计划的直接后果，已避免了 3,035,782 名伤残调整生命年。由于这些健康收益，预计产生了 205 亿美元的经济价值。投资回报率因具体诊断测试而异（结核病为 19.0，HIV 病毒载量测试为 1.4，HIV 婴儿早期诊断为 64.8，SARS-CoV-2 为 2.5），整个分子诊断项目的平均投资回报率为 9.9 2013 年至 2022 年间，每投资 1 美元，价值 9.9 美元。南非的分子诊断计划产生了大量的健康收益以及与这些健康收益相关的经济价值，其投资回报可与儿童疫苗接种等其他高影响力的公共卫生干预措施相媲美。因此，南非的分子诊断计划具有很大的影响力，并将继续成为南非公共卫生支出的一项出色投资。