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Gilbert Kombe, Abt Associates Inc, Suite 600, 4800 Montgomery Lane, Bethesda, MD 20814, ext 274, gilbert_kombe@abtassoc.com, David Galaty, M Sc, International Development, Abt Associates, 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, Chizoba Nwagbara, MBBS, MPH, Division of Epidemiology and Disease Control, Prince George's County Health Department, Cheverly Health Center, 3003 Hospital Drive, Suite 1066, Cheverly, MD 20785, and Owen Smith, MPA, Abt Associates Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814.
Issues: Nigeria is one of many low-resource countries currently launching a comprehensive antiretroviral treatment program. However, many challenges are being encountered and further expansion could benefit from comprehensive cost information. Methods: The study used two interrelated approaches. First, the AIDSTreatCost model was applied to estimate the per-patient cost of providing HAART, Voluntary Counseling and Testing (VCT), and opportunistic infections (OI) treatment. Second, interviews were conducted with ARV providers. Unit cost data and service delivery information was collected from the Federal Ministry of Health and from five sites currently providing ARV treatment. Findings: The total cost of providing HAART is about $591 per patient per year. ARV drugs are a major cost component and contribute 62% ($368) of the total cost. Monitoring tests account for almost 30% ($170) of the total while equipment, training and labor costs contribute about 10%. There are 3 key emerging issues needing urgent attention. First, patients face high out-of-pocket expenditures, accounting for $256 or 43% of the total cost. This is well beyond the means of most Nigerians. Second, there is presently a worrying absence of a consistent and safe supply of ARV drugs. Finally, very few providers have been trained in managing patients on ART, resulting in poor clinical monitoring of patients. Conclusion: The development of an effective national ARV program must include financial support not only for ARV drugs, but all aspects of patient monitoring. Key emerging issues such as drug procurement and provider training must also be addressed before the program expands.
Learning Objectives: "At the conclusion of the session, the participant (learner) in this session will be able to
Keywords: HIV/AIDS, Cost Issues
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Abt Associates
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.