Economic Evaluation and Financing of HIV Interventions and Programmes TUAD1
Please enter your email :
Type:
Oral Abstract Session Back
Venue: Session Room 4
Time: 11:00 - 12:30, 21.07.2009
Code: TUAD1
Chairs: Till Barnighausen, South Africa
James Kahn, United States
Session recording provided by International AIDS Society



Presentations in this session:

11:00
TUAD101
Powerpoint		Overview of economic costing and financing of HIV interventions and programmes
Presented by James Kahn, United States



11:15
TUAD102
Abstract
Powerpoint		The impact of donor agency funding strategies on national responses: the case of Lesotho
Presented by Regien Biesma, Ireland
R. Biesma1, E. Makoa2, P. Odonkor2, L. Tsekoa2, R. Mmpemi2, R. Brugha1
1Royal College of Surgeons in Ireland, Epidemiology and Public Health Medicine, Dublin, Ireland, 2National University of Lesotho, Faculty of Health Sciences, Roma, Lesotho

11:30
TUAD103
Abstract
Powerpoint		Lopinavir/ritonavir (LPV/r)- compared to nevirapine (NVP)-based ART following receipt of single-dose nevirapine (sdNVP) for prevention of mother-to-child HIV transmission in South Africa: a cost-effectiveness analysis of the OCTANE (ACTG A5208) trial
Presented by Andrea Ciaranello, United States
A. Ciaranello1, K. Freedberg2,3, J. Chu2, S. Lockman4,5, M. Hughes6, J. Currier7, J. McIntyre8, E. Losina9,10, R. Walensky1,3,4
1Massachusetts General Hospital, Infectious Disease, Boston, United States, 2Massachusetts General Hospital, Internal Medicine, Boston, United States, 3Harvard Medical School, Center for AIDS Research, Boston, United States, 4Brigham and Women's Hospital, Infectious Disease, Boston, United States, 5Harvard School of Public Health, Immunology and Infectious Disease, Boston, United States, 6Harvard School of Public Health, Biostatistics, Boston, United States, 7University of California Los Angeles, Infectious Disease, Los Angeles, United States, 8University of the Witwatersrand, Perinatal HIV Research Unit, Johannesburg, South Africa, 9Brigham and Women's Hospital, Orthopedic Surgery, Boston, United States, 10Boston University School of Public Health, Biostatistics, Boston, United States

11:45
TUAD104
Abstract
Powerpoint		Cost effectiveness of serum cryptococcal antigen (CRAG) screening to prevent death in HIV- infected persons with CD4 < 100/µL in sub-Saharan Africa
Presented by David Meya, Uganda
D. Meya1, B. Castelnuovo1, A. Kambugu1, Y. Manabe1, P. Bohjanen2, M. Kamya1, D. Boulware2
1Infectious Diseases Institute, Makerere University, Research, Kampala, Uganda, 2Division of Infectious Disease & International Medicine, Department of Medicine, Minneapolis, United States

12:00
TUAD105
Abstract
Powerpoint		Cost analysis of an ARV care programme reaching universal access in Thyolo, Malawi
Presented by Marielle Bemelmans, Malawi
G. Jouquet1, M. Bemelmans2, M. Massaquoi2, L. Arnould1, B. Mwagomba3, A. Bauernfeind1, M. Philips1
1Medecins Sans Frontieres-Belgium, Brussels, Belgium, 2Medecins Sans Frontieres-Belgium, Thyolo, Malawi, 3Ministry of Health, District Health Office, Thyolo, Malawi

Powerpoints presentations
Overview of economic costing and financing of HIV interventions and programmes - Kahn

The impact of donor agency funding strategies on national responses: the case of Lesotho - Biesma

Lopinavir/ritonavir (LPV/r)- compared to nevirapine (NVP)-based ART following receipt of single-dose nevirapine (sdNVP) for prevention of mother-to-child HIV transmission in South Africa: a cost-effectiveness analysis of the OCTANE (ACTG A5208) trial - Ciaranello

Cost effectiveness of serum cryptococcal antigen (CRAG) screening to prevent death in HIV- infected persons with CD4 < 100/µL in sub-Saharan Africa - Meya

Cost analysis of an ARV care programme reaching universal access in Thyolo, Malawi - Bemelmans



Rapporteur report

Track D report by George Schmid


Session:  The source of financing for HIV in Lesotho was remarkably diverse and dependent on donor funding.  The largest donor, MCC at $89 million was far higher than the next donor, at about $25--many donors existed and little national funding was spent.  There were diverse programs in place, partly as a result of the diverse funding.  Limited capacity at government level existed to coordinate efforts.  While scale up of services is needed, more money will not solve many health care system problems in Lesotho without further capacity at government level.

 

An economic study of screening all HIV-positive patients at initiation of ART of patients with a CD4 count <100 with cryptococcal antigen (CRAG) concluded this would be very cost effective.  41 of 311 patients had a positive CRAG.  The authors concluded they needed to screen 11 patients to detect one case and to prevent one death from cryptococcal meningitis, 16 patients needed to be screened at a cost of $266.  A comment from the audience, however, warned that one could not assume that all patients with CRAG progress to cryptococcal antigen, as in their experience only 30% do.  If this is true, the economic analysis of this study will need to be adjusted.  

 

In a session concerning economic evaluation, achieving universal access was attempted in a rural district of Malawi.  Through extensive reorganization of care and task shifting, >80% of those estimated to be in need were placed on ART.  Over three years, 2005-2007, 79% were still alive at the end of 2007.  The average annual recurrent cost for direct care was $237 per patient.  When this cost was spread over the entire population of 600,000 (21% HIV prevalence in the District), the average annual cost to achieve universal access was $3.2 per inhabitant.  This study shows that universal access can be achieved with good clinical results at an affordable price.

 

Conclusion:  Money alone will not be enough to reach universal access.  Capacity building at all levels within some countries will be needed and universal access plans will need to be carefully conceived and implemented.  But, universal access can be achieved in at least some districts.

 


   

   

    The organizers reserve the right to amend the programme.
Contact Us | Site map © 2009 International AIDS Society