The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66962

Owen Smith, Abt Associates, Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, 301-347-5388, Owen_Smith@abtassoc.com and Gilbert Kombe, Abt Associates Inc, Suite 600, 4800 Montgomery Lane, Bethesda, MD 20814.

There is growing national and international interest to make antiretroviral (ARV) treatment available to HIV/AIDS patients in low resource countries. However, limited information exists on how much it would cost to effectively introduce ARV treatment in the developing world. Better knowledge of this issue is crucial for planning purposes and scaling up. To fill this gap, a new policy tool has been developed to estimate costs related to ARV treatment provision by a Ministry of Health in a developing country, under a variety of user-defined, locally inspired policy scenarios. The costing framework is illustrated with results from Uganda and Zambia. Data collection emphasized the use of in-country sources of information, including national ARV policy documents, local cost and epidemiological data, and discussions with providers. The main components included are voluntary counseling, laboratory testing, ARV drugs, drugs for opportunistic infections, treatment monitoring, outpatient and inpatient care, and provider training. Results highlight the need to consider more than just the cost of ARV drugs, and detail the budgetary and human resources required for various models of service delivery. Per-patient and overall program costs for both countries are analyzed in the context of population coverage goals, potential impact on the health budget, and pledges of donor support. Policy implications for Uganda and Zambia as well as potential lessons for others are discussed.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• Describe a policy tool for estimating the costs of antiretroviral (ARV) treatment in low-resource countries.
• Analyze the implications of ARV program costs for population coverage, service delivery, and the HIV/AIDS budgets of government and donor agencies.
• Discuss the policy choices facing ARV program planners in Uganda and Zambia in light of local cost estimates.

Related Web page: www.phrproject.com

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.