Economic analysis of HIV prevention interventions in India

[Guest guest]

Economic analysis of HIV prevention interventions in Andhra Pradesh

state of India to inform resource allocation.

Dandona L, Kumar SGP, Kumar GA, Dandona R.

AIDS 2009, 23:233–242

Objective: To conduct composite economic analysis of HIV prevention

interventions to inform efficient utilization of resources in India.

Methods: We obtained output and economic cost data for the 2005–2006

fiscal year from a representative sample of 128 public-funded HIV

prevention programmes of 14 types in Andhra Pradesh state of India.

Using data from various sources, we developed a model to estimate the

number of HIV infections averted. We estimated the additional HIV

infections that could be averted if each intervention reached optimal

coverage and the associated cost.

Results: In a year, 9688 HIV infections were averted by public-funded

HIV prevention interventions in Andhra Pradesh. Scaling-up

interventions to the optimal level would require US$38.8 million

annually, 2.8 times the US$13.8 million economic cost in

2005–2006. This could increase the number of HIV infections averted

by 2.4-fold, if with higher resources there were many-fold increases

in the proportional allocation for programmes for migrant labourers,

men who have sex with men and voluntary counselling and testing, and

reduction of the high proportion for mass media campaigns

to one-third of the 2005–2006 proportion of resource utilization.

If the proportions of resource allocation for interventions remained

similar to 2005–2006, the higher resources would avert 54% of the

additional avertable HIV infections.

Conclusion: The recent four-fold increase in public funding for

HIV/AIDS control in India should be adequate to scale-up HIV

prevention interventions to an optimal level in Andhra Pradesh, but

the prevention would be suboptimal if additional investments were

not preferentially directed to some particular interventions.

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PS/ The moderator of AIDS INDIA e FORUM has a copy of the text of

this article.