Increasing Efficiency with Scale in HIV Prevention
13/07/2007
Paris France (July 13, 2007): The success of HIV prevention programs and thus millions of lives depend on the efficient use of global resources. New research published in the online open access journal BMC Health Services Research indicates that larger scale HIV prevention programs are 10-100 times more efficient than smaller ones. This holds true across many countries and prevention approaches.
These findings are the result of research by the "Prevent AIDS: Network for Cost-Effectiveness Analysis" (PANCEA) project, a five-country study funded by the US National Institutes of Health to improve HIV prevention funding allocation in low and middle-income countries. A group at the University of California, San Francisco (UCSF) collaborated with Axios International and local researchers to collect 2003 and 2004 cost and output data from 206 HIV prevention programs in India, Mexico, Russia, South Africa, and Uganda. The team investigated the association between scale (quantity of HIV prevention services provided) and cost (costs per unit of service).
"With ever-increasing amounts of HIV/AIDS funding, the international public health community is scaling up HIV/AIDS interventions in developing countries. Cost-effectiveness is becoming a major criterion in HIV/AIDS strategies as the funding is slowly reaching a plateau while patient numbers are increasing exponentially. PANCEA is a leading example of how a collaborative cost-effectiveness analysis will enable reach to millions more people with the same amount of funding", said Joseph Saba, CEO of Axios and a co-author to the research article. "In our voluntary counseling and testing and prevention of mother-to-child transmission programs, we've demonstrated that economies of scale can be achieved through providing services via low-threshold access incorporated within the existing healthcare system.
"The lives of millions of people depend upon how effectively available funds are allocated," said Elliot Marseille, the project director and lead author of the report. "As more PANCEA-type data are collected, it should be possible to add more points to this data set and thus arrive at increasingly precise estimates of the pattern of cost changes with service volume."
"In coming years we anticipate billions of dollars of HIV/AIDS funding, rapidly growing the global prevention effort and hopefully decreasing HIV infections," said Sowedi Muyingo, Vice President of Operations, Axios, and co-investigator in Uganda and South Africa. "Research such as this is essential for informing effective disbursements across a wide range of service types, to expand interventions to an optimal size."
The study evaluated six types of prevention interventions: Voluntary counseling and testing, prevention of mother-to-child transmission, programs for sex workers, programs for injecting drug users, treatment of sexually transmitted infections, and information-education efforts. In all countries and interventions efficiency increased with scale, and unit cost decreased with scale.
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Lisa Menning, Communications and Advocacy Manager
Contact: lisa.menning@axiosint.com or +33 1 44 860 760 (Paris, France)