On lifestyle trends, health and mosquitoes: Formulating welfare levels for control of the Asian tiger mosquito in Greece

The expansion of urban ecosystems and climate change, both outcomes of massive lifestyle changes, contribute to a series of side effects such as environmental deterioration, spread of diseases, increased greenhouse gas emissions and introduction of invasive species. In the case of the Athens metropolitan area, an invasive mosquito species-the Asian tiger mosquito (Aedes albopictus)-has spread widely in the last decade. This spread is favoured within urban environments and is also affected by changing climatic trends. The Asian tiger mosquito is accompanied by risks of mosquito-borne diseases, greater nuisance levels, and increased expenses incurring for its confrontation. The main aims of this paper are (i) to estimate the various costs associated with the control of this invasive species, as well as its health and nuisance impacts, (ii) to evaluate the level of citizens' well-being from averting these impacts and (iii) to record citizens' and experts' perceptions regarding alternative control measures. Evidence shows that experts tend to place a high value on mosquito control when associated with serious health risks, while citizens are more sensitive and concerned about the environmental impacts of control methods. The synthesis of results produced by the current study could act as a preliminary guide for the estimation of societal welfare from the confrontation of similar problems in the context of a complex ecosystem. Author summary This paper is based on several years' collaboration among researchers from various disciplines, key health policy makers and stakeholders in an attempt to evaluate the economic dimensions related to the presence of the Asian Tiger Mosquito (Aedes albopictus) and the challenges of tackling mosquito-borne disease outbreaks in Greece and Southern Europe. Similar studies have been conducted and continue to be published in Europe and the USA examining the socioeconomic benefit from the implementation of relevant control and prevention strategies. These studies conclude that there are significant benefits related both to the reduction of nuisance levels and the reduction of the health risks posed by various mosquito species. In our case, the application of an updated economic analysis on the effectiveness of relevant public control and prevention programs provides essential information for public health decision-making, bearing in mind the significant restructuring of the public sector and the fiscal crisis apparent in the European South.