Estimating the Cost of Typhoid Conjugate Vaccine Delivery in Ghana and the Democratic Republic of the Congo

Typhoid fever remains a significant burden in low- and middle-income countries (LMICs). The World Health Organization recommends incorporating typhoid conjugate vaccines (TCVs) into the routine immunization programs of typhoid-endemic countries. Although TCV has been shown to be safe, well tolerated, and effective, evidence on its delivery costs in African settings remains limited. This study provides economic evidence on the cost of implementing TCV catch-up campaigns. This retrospective provider-perspective costing study evaluated TCV catch-up vaccination campaigns conducted in the Asante-Akim North District of Ghana and the Kisantu Health Zone of the Democratic Republic of the Congo (DRC). The campaigns targeted children aged 9 months to 15 years. An incremental costing approach was used, and a Microsoft Excel-based tool was developed to estimate costs. The total number of vaccinated individuals was 54,814; 10,052 in Ghana and 44,762 in the DRC. The financial cost per fully immunized person (FIP), including vaccine and vaccination supply costs, was estimated at US$ 5.78 in Ghana and US$ 5.47 in the DRC. The corresponding economic costs were estimated at US$ 6.09 in Ghana and US$ 5.89 in the DRC. Vaccine procurement and vaccination supplies represented the largest cost component, accounting for US$ 2.76 per FIP in Ghana and US$ 2.39 per FIP in the DRC, followed by service delivery and service delivery support activities. This study provides empirical estimates of the financial and economic costs of TCV catch-up campaigns in Ghana and the DRC. These findings provide country-specific evidence to inform planning, budgeting, economic evaluation, and policy decisions regarding future TCV introduction in typhoid-endemic settings.