TY - JOUR
T1 - Towards an improved investment approach for an effective response to HIV/AIDS
AU - Schwartländer, Bernhard
AU - Stover, John
AU - Hallett, Timothy
AU - Atun, Rifat
AU - Avila, Carlos
AU - Gouws, Eleanor
AU - Bartos, Michael
AU - Ghys, Peter D.
AU - Opuni, Marjorie
AU - Barr, David
AU - Alsallaq, Ramzi
AU - Bollinger, Lori
AU - De Freitas, Marcelo
AU - Garnett, Geoffrey
AU - Holmes, Charles
AU - Legins, Ken
AU - Pillay, Yogan
AU - Stanciole, Anderson Eduardo
AU - McClure, Craig
AU - Hirnschall, Gottfried
AU - Laga, Marie
AU - Padian, Nancy
N1 - Funding Information:
DB received consultation fees payment from Pangea Global AIDS Foundation and unrelated honoraria from UNAIDS, International Civil Society Support Project and Merck Foundation. GG received grant from the Wellcome Trust and was paid consultancy fees by GlaxoSmithKline, Merck and Sanofi Pasteur MSD for HPV vaccination works. TH received grant from Wellcome Trust for Fellowship and received grants and consultation fees from the Bill & Melinda Gates Foundation. NP received consultation fees from the Bill & Melinda Gates Foundation. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the US Department of State.
PY - 2011
Y1 - 2011
N2 - Substantial changes are needed to achieve a more targeted and strategic approach to investment in the response to the HIV/AIDS epidemic that will yield long-term dividends. Until now, advocacy for resources has been done on the basis of a commodity approach that encouraged scaling up of numerous strategies in parallel, irrespective of their relative effects. We propose a strategic investment framework that is intended to support better management of national and international HIV/AIDS responses than exists with the present system. Our framework incorporates major efficiency gains through community mobilisation, synergies between programme elements, and benefits of the extension of antiretroviral therapy for prevention of HIV transmission. It proposes three categories of investment, consisting of six basic programmatic activities, interventions that create an enabling environment to achieve maximum effectiveness, and programmatic efforts in other health and development sectors related to HIV/AIDS. The yearly cost of achievement of universal access to HIV prevention, treatment, care, and support by 2015 is estimated at no less than US$22 billion. Implementation of the new investment framework would avert 12·2 million new HIV infections and 7·4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches, and result in 29·4 million life-years gained. The framework is cost effective at $1060 per life-year gained, and the additional investment proposed would be largely offset from savings in treatment costs alone.
AB - Substantial changes are needed to achieve a more targeted and strategic approach to investment in the response to the HIV/AIDS epidemic that will yield long-term dividends. Until now, advocacy for resources has been done on the basis of a commodity approach that encouraged scaling up of numerous strategies in parallel, irrespective of their relative effects. We propose a strategic investment framework that is intended to support better management of national and international HIV/AIDS responses than exists with the present system. Our framework incorporates major efficiency gains through community mobilisation, synergies between programme elements, and benefits of the extension of antiretroviral therapy for prevention of HIV transmission. It proposes three categories of investment, consisting of six basic programmatic activities, interventions that create an enabling environment to achieve maximum effectiveness, and programmatic efforts in other health and development sectors related to HIV/AIDS. The yearly cost of achievement of universal access to HIV prevention, treatment, care, and support by 2015 is estimated at no less than US$22 billion. Implementation of the new investment framework would avert 12·2 million new HIV infections and 7·4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches, and result in 29·4 million life-years gained. The framework is cost effective at $1060 per life-year gained, and the additional investment proposed would be largely offset from savings in treatment costs alone.
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U2 - 10.1016/S0140-6736(11)60702-2
DO - 10.1016/S0140-6736(11)60702-2
M3 - Comment/debate
C2 - 21641026
AN - SCOPUS:79958765666
SN - 0140-6736
VL - 377
SP - 2031
EP - 2041
JO - The Lancet
JF - The Lancet
IS - 9782
ER -