{
  "modelVersion": "0.1",
  "preparedOn": "2026-10-18",
  "budgetUSD": 100,
  "estimateType": "Illustrative program-cost scenario; gross acute benefit",
  "currency": "USD",
  "currencyYear": 2026,
  "currencyBasis": "Nominal planning assumptions chosen in October 2026; not a conversion of historical ETB or PPP international dollars.",
  "population": "Adults with persistent podoconiosis lymphoedema, similar to participants in the northern Ethiopian GoLBeT trial.",
  "counterfactual": "No additional comparable supported foot-care package during the credited first year.",
  "referenceIntensityHours": 47.25,
  "intensityExponent": 1,
  "creditedYears": 1,
  "assumedDaysPerAttack": 3,
  "reportedEvidence": {
    "trial": {
      "source": "P1",
      "participants": 696,
      "interventionAttackRatePerPersonYear": 19.4,
      "controlAttackRatePerPersonYear": 23.9,
      "absoluteAttackRateReduction": 4.5,
      "absoluteReduction95CI": [
        3.8,
        5.1
      ],
      "endpoint": "Acute dermatolymphangioadenitis attacks per person-year; intention-to-treat analysis with available diaries."
    },
    "historicalCost": {
      "source": "P2",
      "ETBPerParticipant": 2419,
      "suppliesETB": 529,
      "deliveryETB": 1890,
      "internationalDollarsPPP2016": 314,
      "isUSD": false,
      "included": "Trial-based first-year provider delivery, supplies and training; imperfect separation from research costs.",
      "useInModel": "Context only. Not substituted for a current US-dollar price."
    }
  },
  "choices": {
    "cost": "US$200 per additional adult supported for a full year is an illustrative WSI budget assumption, not a verified price. US$100 and US$300 test sensitivity. Intended provider scope: supplies, training, supervision, follow-up, transport and administration; household costs excluded.",
    "effectRetention": "Retain 50% of the trial absolute attack-rate reduction centrally, with 25% and 100% scenarios. A judgment about transfer to a future similar program, not a measured success probability. No further adherence or success multiplier.",
    "duration": "Three days per avoided attack is an assumed course, not an arithmetic mean measured by the trial. WHO describes acute attacks causing 3–5 bedbound days. No benefit from shortening remaining attacks is added.",
    "intensity": "Average intensity 3 on the WSI 0–10 scale, across all hours of each assumed attack including sleep and milder periods. WSI judgment, not a validated clinical mapping. Alternatives 2 and 4.",
    "additionality": "Conditional on paying for additional full-year care that would otherwise not occur. No claim about what a new unrestricted donation purchases.",
    "harms": "Treatment burdens and adverse effects are unestimated. Headline is gross avoided acute suffering, not complete net benefit."
  },
  "scenarios": {
    "lower": {
      "label": "Lower",
      "costPerParticipantYearUSD": 300,
      "effectRetention": 0.25,
      "intensity": 2,
      "outputsPer100USD": {
        "participantYearEquivalents": 0.3333333333333333,
        "attacksAverted": 0.375,
        "acuteDaysAverted": 1.125,
        "grossUSUAverted": 1.1428571428571428,
        "deathsPrevented": null,
        "netUSU": null
      }
    },
    "central": {
      "label": "Central",
      "costPerParticipantYearUSD": 200,
      "effectRetention": 0.5,
      "intensity": 3,
      "outputsPer100USD": {
        "participantYearEquivalents": 0.5,
        "attacksAverted": 1.125,
        "acuteDaysAverted": 3.375,
        "grossUSUAverted": 5.142857142857143,
        "deathsPrevented": null,
        "netUSU": null
      }
    },
    "higher": {
      "label": "Higher",
      "costPerParticipantYearUSD": 100,
      "effectRetention": 1,
      "intensity": 4,
      "outputsPer100USD": {
        "participantYearEquivalents": 1.0,
        "attacksAverted": 4.5,
        "acuteDaysAverted": 13.5,
        "grossUSUAverted": 27.428571428571427,
        "deathsPrevented": null,
        "netUSU": null
      }
    },
    "no_effect": {
      "label": "No effect",
      "costPerParticipantYearUSD": 200,
      "effectRetention": 0,
      "intensity": 3,
      "outputsPer100USD": {
        "participantYearEquivalents": 0.5,
        "attacksAverted": 0.0,
        "acuteDaysAverted": 0.0,
        "grossUSUAverted": 0.0,
        "deathsPrevented": null,
        "netUSU": null
      }
    }
  },
  "deathsPrevented": null,
  "netUSU": null,
  "remainingFundingGapUSD": null,
  "unestimated": [
    "Chronic swelling and discomfort",
    "Psychological and stigma-related relief",
    "Caregiver effects",
    "Treatment harms and burden of daily self-care",
    "Household costs and patient time",
    "Benefits beyond year one",
    "Shortening attacks that still occur",
    "Deaths prevented"
  ],
  "sources": [
    {
      "id": "P1",
      "title": "Negussie et al. (2018): GoLBeT randomized trial",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6562300/",
      "use": "Primary attack-rate effect, Table 2; trial design and limitations. DOI: 10.1016/S2214-109X(18)30124-4."
    },
    {
      "id": "P2",
      "title": "Hounsome et al. (2019): GoLBeT economic evaluation",
      "url": "https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007780",
      "use": "Costing methods, Table 1 and intervention-cost results. Historical ETB and 2016 PPP international dollars, not current US dollars."
    },
    {
      "id": "P3",
      "title": "WHO (2023): Podoconiosis fact sheet",
      "url": "https://www.who.int/news-room/fact-sheets/detail/podoconiosis-(non-filarial-lymphoedema)",
      "use": "Condition, painful acute attacks and care context. Does not supply a USU intensity."
    },
    {
      "id": "P4",
      "title": "Footwork International: current work and 2026–2031 strategy",
      "url": "https://www.footwork.international/",
      "use": "Reviewed 18 October 2026. Active public initiative and donation route; no verified current delivery price or remaining funding gap."
    }
  ],
  "interpretation": "Scenarios are illustrative assumptions, not confidence limits or a ranking. Fractional participant-years represent averages across full-year care packages, not delivery of partial courses. No organization has endorsed this model."
}