The Global Impact of Scaling-Up HIV/AIDS Prevention Programs in Low and Middle-Income Countries

Harvard University, Cambridge, Massachusetts, United States
Science (Impact Factor: 33.61). 04/2006; 311(5766):1474-6. DOI: 10.1126/science.1121176
Source: PubMed


A strong, global commitment to expanded prevention programs targeted at sexual transmission and transmission among injecting drug users, started now, could avert 28 million new HIV infections between 2005 and 2015. This figure is more than half of the new infections that might otherwise occur during that period in 125 low- and middle-income countries. Although preventing these new infections would require investing about U.S.$122 billion over this period, it would reduce future needs for treatment and care. Our analysis suggests that it will cost about U.S.$3900 to prevent each new infection, but that this will produce a savings of U.S.$4700 in forgone treatment and care costs. Thus, greater spending on prevention now would not only prevent more than half the new infections that would occur from 2005 to 2015 but would actually produce a net financial saving as future costs for treatment and care are averted.

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    • "It has become clichéd to talk of the gaps between policy and action, rhetoric and reality – and yet gaps in coverage and implementation are highlighted time and time again in our primary research. 20 There is as yet no systematic attempt to learn from other sectors – particularly health sectors such as HIV/AIDS or tuberculosis treatment (Bekker, Myer, Orrell, Lawn, & Wood, 2008; Keshavjee & Farmer, 2010; Stover et al., 2006; Stringer et al., 2006) – which have attempted to scale up treatment and prevention fast. There is little knowledge as yet of the links between capacity of individual frontline or mid-level workers, the organisations that employ them, and the system as a whole (Potter & Brough, 2004). "
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    • "Given the magnitude of the problem and the high level of uncertainly regarding comparative effectiveness of interventions, it is imperative that roll-out of large-scale prevention programs incorporate rigorous prospective evaluations of their effectiveness. [10] Its alarming to know that the use of Condom is not practiced in many parts of Europe, and that too in unsafe commercial sexual encounters. The non usage of such a cheap, widely available and easily disposable measure may definitely be posing great threats, towards which timely urgent, sustained and effective attention of the authorities is required. "

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    • "High-income countries were excluded because of several reasons: the bulk of the new infections come from low- and middle-income economies, and thus it is in those countries where the largest impact in terms of HIV infections averted can be made; more developed countries have more resources to spend on health and with relatively less scarcity comes less competition for life-saving interventions; the differences in transmission types and the socio-cultural context warrant a separate analysis by income level [1,16,17]. "
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