Cost-effectiveness

Published on June 13, 2012 by

Measuring the performance of ART programmes in Sub-Saharan Africa

The HIV epidemic is becoming financially unsustainable. It is therefore essential to assess the effectiveness and cost-effectiveness of different HIV treatment programmes and models so that the existing limited resources can be allocated optimally. Data are gathered periodically to measure the retention of patients on ART after treatment enrolment at the national level, though this data collection is often complicated by patients lost to follow-up. However, little work so far has assessed the performance (effectiveness and cost-effectiveness) of ART programs differing by the kind of providers and subsequently identified the “good” versus “bad” performers. Identifying the determinants of good performance for ART programmes is essential. Decision-makers will then be able to potentially improve ART delivery in countries.

Short item Published on November 28, 2011

Modelling the potential impact of an antiretroviral microbicide gel on the HIV epidemic in South Africa

One of the major obstacles to preventing HIV-transmission has been the lack of an effective, female controlled method of prevention. Now, for the first time, a vaginal microbicide has been shown to reduce the risk of infection in women. CAPRISA 004 was a randomized placebo-controlled trial to assess the effectiveness and safety of a 1% Read More

Published on June 13, 2011 by

Evaluating the cost-effectiveness of pre-exposure prophylaxis (PrEP) and its impact on HIV-1 transmission in South Africa

The focus of this paper is to evaluate PrEP alongside ART and condom-use interventions in South Africa, informed by national HIV and demographical surveys. The age-structured model we developed pays close attention to the distribution of relative infection risks between age categories. It includes dynamical effects usually not explicitly modelled, such as age-dependent condom use and partner choice. Despite some the limitations of the model, the model offers a relatively simple approach to studying the impact of PrEP in the context of national and generalized HIV epidemics. The inclusion of an age variable offers a direct way of studying age-structured prioritising strategies.

Published on November 30, 2010 by

Microbicides: the end of the beginning, not the beginning of the end

After two decades of setbacks with microbicide trials, recently two studies demonstrated a proof of concept for microbicides for the first time. With now a demonstrated proof of concept, understanding the potential cost-effectiveness of vaginal microbicides within the currently existing set of HIV prevention interventions becomes crucial. As there it not yet a safe and effective microbicide available, the challenge is to evaluate the potential of the microbicide technology for a hypothetical intervention. Results are reported of a recent study that looked at a potential 1-year intervention targeting a population of women in reproductive age in South Africa and estimated the incremental cost-effectiveness over a year of microbicides when distributed in conjunction with condoms.

Short item Published on September 25, 2009

Interaction of malaria and HIV

Malaria and HIV/AIDS are two of the most important infectious diseases worldwide, and although there is good evidence of a biological interaction between them, research into malaria and HIV continues to be largely separate. Furthermore, despite the fact that malaria and HIV/AIDS prevention and control programmes are being scaled up, they continue to be planned Read More