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Owen Smith, MPA, Abt Associates Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301-347-5388, Owen_Smith@abtassoc.com
There is growing international interest to make antiretroviral treatment available to HIV/AIDS patients in low resource countries. Billions of dollars are being pledged to make these ARV programs a reality, yet limited work has been done at the country level to determine how much it would cost to implement them, and the policy issues that would ensue. This study examines the total costs and resource requirements of a comprehensive ARV program, and discusses the broader policy implications that follow from these results. The starting point of the analysis is fieldwork conducted in Zambia, Uganda, and Nigeria. Data collection emphasized the use of in-country sources of information, including national ARV policy documents, local cost data, and provider interviews. The costs of voluntary counseling and testing (VCT), opportunistic infection (OI) treatment, and antiretroviral therapy (ART) are included. In all countries, results emphasize the importance of costs over and above those associated with drugs alone. On a per-patient basis the costs of monitoring tests and other inputs may account for as much as half the total; from a programmatic standpoint the costs of supporting services such as VCT and OI treatment are substantial yet easily overlooked. Also, calculations indicate that for certain countries the human resource constraint is likely to bind earlier than the financial constraint. Results are used to illustrate what current donor pledges such as the WHO's 3x5 initiative might look like regarding resource requirements. Common cross-country themes and critical policy issues such as financial sustainability will also be highlighted.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.