The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There?
The 2013 Lancet Commission Report, Global Health 2035, rightly pointed out that we are at a unique place in history where a “grand convergence” of health initiatives to reduce both infectious diseases, and child and maternal mortality – diseases that still plague low income countries – would yield good returns in terms of development and health outcomes. This would also be a good economic investment. Such investments would support achieving health goals of reducing under-five (U5) mortality to 16 per 1 000 live births, reducing deaths due to HIV/AIDS to 8 per 100 000 population, and reducing annual TB deaths to 4 per 100 000 population. Treatment as prevention (TasP) holds enormous potential in reducing HIV transmission, and morbidity and mortality associated with HIV/AIDS – and therefore contributing to Global Health 2035 goals. However, TasP requires large financial investments and poses significant implementation challenges. In this review, we discuss the potential effectiveness, financing and implementation of TasP. Overall, we conclude that TasP shows great promise as a cost-effective intervention to address the dual aims of reducing new HIV infections and reducing the global burden of HIV-related disease. Successful implementation will be no easy feat, though. The dramatic increases in the numbers of persons who need antiretroviral therapy (ART) under a TasP approach will pose enormous challenges at all stages of the HIV treatment cascade: HIV diagnosis, antiretroviral (ARV) initiation, ARV adherence and retention, and increased drug resistance with long-term enrollment on ART. Overcoming these implementation challenges will require targeted implementation, not focusing exclusively on TasP, most-at-risk population (MARP)-friendly services for key populations, integrating services, task shifting, more efficient program management, balancing supply and demand, integration into universal health coverage efforts, demand creation, improved ART retention and adherence strategies, the use of incentives to improve HIV treatment outcomes and reduce unit costs, continued operational research and tapping into technological innovations.
Main Authors: | , , , |
---|---|
Format: | Journal Article biblioteca |
Language: | en_US |
Published: |
Taylor and Francis
2014-07-21
|
Subjects: | antiretroviral therapy, cost-effectiveness, health impact, HIV/AIDS, drug resistance, health program enrollment, adherence strategies, |
Online Access: | http://hdl.handle.net/10986/20478 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
dig-okr-1098620478 |
---|---|
record_format |
koha |
spelling |
dig-okr-10986204782021-04-23T14:03:56Z The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There? Wilson, David Taaffe, Jessica Fraser-Hurt, Nicole Gorgens, Marelize antiretroviral therapy cost-effectiveness health impact HIV/AIDS drug resistance health program enrollment adherence strategies The 2013 Lancet Commission Report, Global Health 2035, rightly pointed out that we are at a unique place in history where a “grand convergence” of health initiatives to reduce both infectious diseases, and child and maternal mortality – diseases that still plague low income countries – would yield good returns in terms of development and health outcomes. This would also be a good economic investment. Such investments would support achieving health goals of reducing under-five (U5) mortality to 16 per 1 000 live births, reducing deaths due to HIV/AIDS to 8 per 100 000 population, and reducing annual TB deaths to 4 per 100 000 population. Treatment as prevention (TasP) holds enormous potential in reducing HIV transmission, and morbidity and mortality associated with HIV/AIDS – and therefore contributing to Global Health 2035 goals. However, TasP requires large financial investments and poses significant implementation challenges. In this review, we discuss the potential effectiveness, financing and implementation of TasP. Overall, we conclude that TasP shows great promise as a cost-effective intervention to address the dual aims of reducing new HIV infections and reducing the global burden of HIV-related disease. Successful implementation will be no easy feat, though. The dramatic increases in the numbers of persons who need antiretroviral therapy (ART) under a TasP approach will pose enormous challenges at all stages of the HIV treatment cascade: HIV diagnosis, antiretroviral (ARV) initiation, ARV adherence and retention, and increased drug resistance with long-term enrollment on ART. Overcoming these implementation challenges will require targeted implementation, not focusing exclusively on TasP, most-at-risk population (MARP)-friendly services for key populations, integrating services, task shifting, more efficient program management, balancing supply and demand, integration into universal health coverage efforts, demand creation, improved ART retention and adherence strategies, the use of incentives to improve HIV treatment outcomes and reduce unit costs, continued operational research and tapping into technological innovations. 2014-10-28T18:49:58Z 2014-10-28T18:49:58Z 2014-07-21 Journal Article African Journal of AIDS Research 1608-5906 http://hdl.handle.net/10986/20478 en_US CC BY-NC-ND 3.0 IGO http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Taylor and Francis Publications & Research :: Journal Article |
institution |
Banco Mundial |
collection |
DSpace |
country |
Estados Unidos |
countrycode |
US |
component |
Bibliográfico |
access |
En linea |
databasecode |
dig-okr |
tag |
biblioteca |
region |
America del Norte |
libraryname |
Biblioteca del Banco Mundial |
language |
en_US |
topic |
antiretroviral therapy cost-effectiveness health impact HIV/AIDS drug resistance health program enrollment adherence strategies antiretroviral therapy cost-effectiveness health impact HIV/AIDS drug resistance health program enrollment adherence strategies |
spellingShingle |
antiretroviral therapy cost-effectiveness health impact HIV/AIDS drug resistance health program enrollment adherence strategies antiretroviral therapy cost-effectiveness health impact HIV/AIDS drug resistance health program enrollment adherence strategies Wilson, David Taaffe, Jessica Fraser-Hurt, Nicole Gorgens, Marelize The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There? |
description |
The 2013 Lancet Commission Report, Global Health 2035, rightly pointed out that we are at a unique place in history where a “grand convergence” of health initiatives to reduce both infectious diseases, and child and maternal mortality – diseases that still plague low income countries – would yield good returns in terms of development and health outcomes. This would also be a good economic investment. Such investments would support achieving health goals of reducing under-five (U5) mortality to 16 per 1 000 live births, reducing deaths due to HIV/AIDS to 8 per 100 000 population, and reducing annual TB deaths to 4 per 100 000 population.
Treatment as prevention (TasP) holds enormous potential in reducing HIV transmission, and morbidity and mortality associated with HIV/AIDS – and therefore contributing to Global Health 2035 goals. However, TasP requires large financial investments and poses significant implementation challenges.
In this review, we discuss the potential effectiveness, financing and implementation of TasP. Overall, we conclude that TasP shows great promise as a cost-effective intervention to address the dual aims of reducing new HIV infections and reducing the global burden of HIV-related disease. Successful implementation will be no easy feat, though. The dramatic increases in the numbers of persons who need antiretroviral therapy (ART) under a TasP approach will pose enormous challenges at all stages of the HIV treatment cascade: HIV diagnosis, antiretroviral (ARV) initiation, ARV adherence and retention, and increased drug resistance with long-term enrollment on ART. Overcoming these implementation challenges will require targeted implementation, not focusing exclusively on TasP, most-at-risk population (MARP)-friendly services for key populations, integrating services, task shifting, more efficient program management, balancing supply and demand, integration into universal health coverage efforts, demand creation, improved ART retention and adherence strategies, the use of incentives to improve HIV treatment outcomes and reduce unit costs, continued operational research and tapping into technological innovations. |
format |
Journal Article |
topic_facet |
antiretroviral therapy cost-effectiveness health impact HIV/AIDS drug resistance health program enrollment adherence strategies |
author |
Wilson, David Taaffe, Jessica Fraser-Hurt, Nicole Gorgens, Marelize |
author_facet |
Wilson, David Taaffe, Jessica Fraser-Hurt, Nicole Gorgens, Marelize |
author_sort |
Wilson, David |
title |
The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There? |
title_short |
The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There? |
title_full |
The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There? |
title_fullStr |
The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There? |
title_full_unstemmed |
The Economics, Financing and Implementation of HIV Treatment as Prevention : What Will it Take to Get There? |
title_sort |
economics, financing and implementation of hiv treatment as prevention : what will it take to get there? |
publisher |
Taylor and Francis |
publishDate |
2014-07-21 |
url |
http://hdl.handle.net/10986/20478 |
work_keys_str_mv |
AT wilsondavid theeconomicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere AT taaffejessica theeconomicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere AT fraserhurtnicole theeconomicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere AT gorgensmarelize theeconomicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere AT wilsondavid economicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere AT taaffejessica economicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere AT fraserhurtnicole economicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere AT gorgensmarelize economicsfinancingandimplementationofhivtreatmentaspreventionwhatwillittaketogetthere |
_version_ |
1756573785450872832 |