Reorienting the HIV Response in Niger Toward Sex Work Interventions

Fraser, Nicole; Kerr, Cliff C.; Harouna, Zakou; Alhousseini, Zeinabou; Cheikh, Nejma; Gray, Richard T.; Shattock, Andrew J.; Wilson, David; Haacker, Markus; Shubber, Zara; Masaki, Emiko; Karamoko, Djibrilla; Görgens, Marelize

doi:10.1097/qai.0000000000000456

Cited by 15 publications

(7 citation statements)

References 5 publications

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“…Some mathematical modelling studies have explored the effects of constraints on the cost-effectiveness of ART treatment strategies in SSA. Cleary et al, Fraser et al, and Anderson et al determined the optimal treatment strategies within the available budgets for South Africa [ 10 ], Nigeria [ 11 ], and Kenya [ 12 ], respectively. Recently, Hontelez et al determined the cost-effectiveness of ART for all HIV-infected people within different scenarios of supply- and demand-side constraints for ten countries in SSA [ 2 ].…”

Section: Moving Forwardmentioning

confidence: 99%

Evidence for scaling up HIV treatment in sub-Saharan Africa: A call for incorporating health system constraints

et al. 2017

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Section: Moving Forwardmentioning

confidence: 99%

Evidence for scaling up HIV treatment in sub-Saharan Africa: A call for incorporating health system constraints

et al. 2017

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“…6 The distribution of domestic funding across countries in SSA directly reflects neither disease burden nor financial need, 7 whilst international donors vary in how they prioritise countries; but a better funding configuration has not been offered. Some previous studies have argued for targeting HIV treatment and prevention efforts by geography 8 or risk group, 9 and reaching marginalised high-risk populations is widely viewed as crucial to epidemic control. 10 However, it is not always clear what priority these concerns receive in programmes over other considerations such as achieving scale or rolling out new interventions.…”

Section: Introductionmentioning

confidence: 99%

Optimum resource allocation to reduce HIV incidence across sub-Saharan Africa: a mathematical modelling study

et al. 2016

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“…Allocative efficiency can be quantitatively analyzed via mathematical and economic modelling, using data on epidemiology, programme expenditure and intervention effectiveness (under setting-specific political and implementation constraints). Such analyses can estimate the combination of programmes likely to have greatest impact against defined health objectives and in turn inform resource allocation planning [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

In the interests of time: improving HIV allocative efficiency modelling via optimal time‐varying allocations

Shattock

Kerr

Stuart

et al. 2016

Journal of the International AIDS Society

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IntroductionInternational investment in the response to HIV and AIDS has plateaued and its future level is uncertain. With many countries committed to ending the epidemic, it is essential to allocate available resources efficiently over different response periods to maximize impact. The objective of this study is to propose a technique to determine the optimal allocation of funds over time across a set of HIV programmes to achieve desirable health outcomes.MethodsWe developed a technique to determine the optimal time-varying allocation of funds (1) when the future annual HIV budget is pre-defined and (2) when the total budget over a period is pre-defined, but the year-on-year budget is to be optimally determined. We use this methodology with Optima, an HIV transmission model that uses non-linear relationships between programme spending and associated programmatic outcomes to quantify the expected epidemiological impact of spending. We apply these methods to data collected from Zambia to determine the optimal distribution of resources to fund the right programmes, for the right people, at the right time.Results and discussionConsidering realistic implementation and ethical constraints, we estimate that the optimal time-varying redistribution of the 2014 Zambian HIV budget between 2015 and 2025 will lead to a 7.6% (7.3% to 7.8%) decrease in cumulative new HIV infections compared with a baseline scenario where programme allocations remain at 2014 levels. This compares to a 5.1% (4.6% to 5.6%) reduction in new infections using an optimal allocation with constant programme spending that recommends unrealistic programmatic changes. Contrasting priorities for programme funding arise when assessing outcomes for a five-year funding period over 5-, 10- and 20-year time horizons.ConclusionsCountries increasingly face the need to do more with the resources available. The methodology presented here can aid decision-makers in planning as to when to expand or contract programmes and to which coverage levels to maximize impact.

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Reorienting the HIV Response in Niger Toward Sex Work Interventions

Cited by 15 publications

References 5 publications

Evidence for scaling up HIV treatment in sub-Saharan Africa: A call for incorporating health system constraints

Evidence for scaling up HIV treatment in sub-Saharan Africa: A call for incorporating health system constraints

Optimum resource allocation to reduce HIV incidence across sub-Saharan Africa: a mathematical modelling study

In the interests of time: improving HIV allocative efficiency modelling via optimal time‐varying allocations

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