International AIDS and Economics Network and the latest research in the economics of aids
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Transcript of International AIDS and Economics Network and the latest research in the economics of aids
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INTERNATIONAL AIDS AND ECONOMICS NETWORK AND THE
LATEST RESEARCH IN THE ECONOMICS OF AIDS
Steven Forsythe, PhDHealth EconomistPresident of the International AIDS Economics NetworkFutures Institute
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BACKGROUND OF IAEN
• 21 year old network dedicated to economists and policymakers working in the field of HIV/AIDS
• Has provided face-to-face meetings prior to IAS since 2000
• Operates a LinkedIn group since 2010 (International AIDS Economics Network Group)• Currently over 5,000 members
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BILL AND MELINDA GATES FOUNDATION GRANT TO IAEN
BMGF 3 year grant has 3 objectives:• Build capacity in 4 African countries (Zambia, Tanzania, Malawi and
Uganda)• Fund special economic studies in 6 countries (Zambia, Tanzania,
Malawi, Uganda, Kenya, South Africa)• Disseminate globally information about AIDS and economics
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2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
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Resources People On Treatment New Infections
International Commitments to AIDS
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RELEVANT TOPICS AT IAEN• Efficiency and Effectiveness (7)
• Financing (4)
• Sustainability and Investment Case (3)
• Costing (3)
• Socioeconomic Impact (1)
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TREATMENT• Routine laboratory monitoring for toxicity, as prescribed by the WHO 2013
Guidelines is particularly expensive and may not provide measurable clinical benefits. - Charles Gilks, University of Queensland
• Why the 2013 WHO treatment guidelines may reduce the need for human resources. – Samantha Diamond, CHAI
• Why are countries such as Mexico spending so much on treatment? – Claire Chaumont, INSP
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CIRCUMCISION• It makes sense to target by age and in some cases by subnational level.
The most cost-effective age to circumcise is 15-29 or 15-34 in Sub-Saharan Africa. – Katharine Kripke, Futures Institute
• Early infant male circumcision in Zimbabwe is cheaper for AccuCirc ($52) than for Mogen Clamp ($58). It is also much cheaper when performed by a nurse ($38) rather than a doctor ($52) - Karin Hatzold, PSI
• “Free” male circumcision remains too expensive for many men in Lesotho and Namibia. – Tigistu Adamu, JHPIEGO
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COSTING• Eastern European/Central Asian countries face rapid
reductions in international resources for harm reduction. A barrier to replacing these resources is the lack of information about the cost of effective harm reduction services. - Danielle Parsons, APMGlobal Health
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COST-EFFECTIVENESS• The cost per infection averted in Zimbabwe range between $335 and $538. A
combined community and health facility approach has the potential to improve access and retention across the PMTCT cascade. - Ravikanthi Rapiti, Population Council.
• We know much more now than a decade ago about unit costs and cost drivers. We need to be able to continue work in technical efficiencies with a particular focus on not just research, but also policy change. – Marelize Gorgens, World Bank
• An analysis of MSM in Mexico revealed which interventions are effective at changing behaviors and which interventions are not. – Sergio Bautista, INSP
• The economic consequences of different HIV interventions can vary significantly. The example of male circumcision was cited as an intervention which can have very positive long term economic consequences on a country. – Markus Haacker
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FINANCING• Donor government funding commitments to address HIV in
low- and middle-income countries fell in 2013 by 8% - Jennifer Kates, Kaiser Family Foundation
• A modestly effective vaccine does reduce new infections significantly, but a highly effective vaccine is needed to get “close to zero” and to provide the cost-effectiveness needed to support broad access - Arne Näveke, International AIDS Vaccine Initiative
• Global HIV Prevention R&D Investment declined from 2012 to 2013 by 4%. This included a decline of 14% in microbicides and 3% in vaccine development. - Emily Donaldson, AVAC: Global Advocacy for HIV Prevention
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SUSTAINABILITY• An analysis of Botswana’s Investment Case reveals limited
options for sustaining the country’s response. Additional investments in health system strengthening are likely to be key for Botswana to achieve universal access. – Peter Stegman, Futures Institute.
• In Bosnia, HIV/AIDS and TB are two of the only effective national programs in the country. However, they rely on funding from the Global Fund, which will be discontinued in 2015. - Dave Burrows, APMGlobal Health.
• CHAPS found that their male circumcision program in South Africa was more sustainable if given a fixed-price contract rather than a cooperative agreement. - Dino Rech, CHAPS
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CONCLUSION• Data from cited studies will be available on the
www.iaen.org website and the International AIDS Economics Network group on Linkedin