TY - JOUR
T1 - Costing human rights and community support interventions as a part of universal access to HIV treatment and care in a Southern African Setting
AU - Jones, Louisa
AU - Akugizibwe, Paula
AU - Clayton, Michaela
AU - Amon, Joseph J.
AU - Sabin, Miriam Lewis
AU - Bennett, Rod
AU - Stegling, Christine
AU - Baggaley, Rachel
AU - Kahn, James G.
AU - Holmes, Charles B.
AU - Garg, Navneet
AU - Obermeyer, Carla Makhlouf
AU - Defilippo Mack, Christina
AU - Williams, Phoebe
AU - Smyth, Caoimhe
AU - Vitoria, Marco
AU - Crowley, Siobhan
AU - Williams, Brian
AU - Mcclure, Craig
AU - Granich, Reuben
AU - Hirnschall, Gottfried
PY - 2011/9
Y1 - 2011/9
N2 - Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, 'Know Your Rights' information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall programmes costs. ART programs should consider measuring the cost and impact of human rights and community support interventions as key aspects of successful programme expansion.
AB - Expanding access to antiretroviral therapy (ART) has both individual health benefits and potential to decrease HIV incidence. Ensuring access to HIV services is a significant human rights issue and successful programmes require adequate human rights protections and community support. However, the cost of specific human rights and community support interventions for equitable, sustainable and non-discriminatory access to ART are not well described. Human rights and community support interventions were identified using the literature and through consultations with experts. Specific costs were then determined for these health sector interventions. Population and epidemic data were provided through the Statistics South Africa 2009 national mid-year estimates. Costs of scale up of HIV prevention and treatment were taken from recently published estimates. Interventions addressed access to services, minimising stigma and discrimination against people living with HIV, confidentiality, informed consent and counselling quality. Integrated HIV programme interventions included training for counsellors, 'Know Your Rights' information desks, outreach campaigns for most at risk populations, and adherence support. Complementary measures included post-service interviews, human rights abuse monitoring, transportation costs, legal assistance, and funding for human rights and community support organisations. Other essential non-health sector interventions were identified but not included in the costing framework. The annual costs for the human rights and community support interventions are United States (US) $63.8 million (US $1.22 per capita), representing 1.5% of total health sector HIV programme costs. Respect for human rights and community engagement can be understood both as an obligation of expanded ART programmes and as a critically important factor in their success. Basic rights-based and community support interventions constitute only a small percentage of overall programmes costs. ART programs should consider measuring the cost and impact of human rights and community support interventions as key aspects of successful programme expansion.
KW - Cost analysis
KW - HAART
KW - HIV prevention
KW - economics
KW - highly active antiretroviral therapy
KW - human rights
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U2 - 10.2174/157016211798038614
DO - 10.2174/157016211798038614
M3 - Article
C2 - 21999777
AN - SCOPUS:80055067579
SN - 1570-162X
VL - 9
SP - 416
EP - 428
JO - Current HIV research
JF - Current HIV research
IS - 6
ER -