AEGiS-13IAC: Should HIV post exposure prophylaxis be made available for all health workers in Namibia and at what cost?

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Should HIV post exposure prophylaxis be made available for all health workers in Namibia and at what cost?

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrC312)

Van der Veen F, Joyce N
F. Van der Veen, EC/NACOP-Ministry of Health, P.O. Box 22331-Bachbrecht, Windhoek, Namibia, Tel.: +264 61 203 21 98, Fax: +264 61 22 41 55, E-mail: nacp@iafrica.com.na

OBJECTIVES: To estimate annual cost of the introduction of post exposure prophylaxis (PEP) at the Windhoek Central Hospital Complex WCHC and to make projections for the annual cost of nation-wide introduction of PEP using different scenarios.

METHODS: Existing reports on sharp injuries, which occurred during the period April 1991-March 1999 at the (WCHC) were compiled and analysed. Information on the cost of antiretroviral (ARV) drugs was obtained from the manufacturer, wholesalers and from local private pharmacies. The cost of one episode of PEP was calculated as well as the total cost per year for the last 3 years for all cases for which PEP would have been indicated.

RESULTS: The annual number of reported injuries dropped from 111 in the fiscal year (FY) 1991 to 37 during the FY 1996. Thereafter the number of injuries increased again to 57 in 1998. There has been a continuous increase of reported injuries involving positive sources (from 7 in 1991 to 18 in 1998 and there has been a reduction in stick injuries involving unknown sources (from 10 in 1991 to 3 in 1998. The annual cost of PEP prophylaxis for staff at the WCHC is calculated at USD 2,028 for AZT and USD 2,124 for AZT+3TC (Combivir). The annual drug cost of PEP for the entire country is estimated at USD 38,690 for AZT+3TC. This cost may be reduced by about 40% by reducing the incidence of injuries to a similar low level as the CWHC. Further cost reduction could be obtained by reducing the interval between the injury and the reception of HIV results. Cost recovery for health workers covered by medical aid could further reduce the cost for the Ministry of Health and Social services for another 40%. The cost per sero-conversion averted is calculated at USD 54,311.

CONCLUSION: Introduction PEP for health workers is affordable within the context Namibian context in particular if appropriate measures for prevention, monitoring and cost recovery are introduced simultaneously.

Keywords: AEGIS, Anti-HIV Agents, Zidovudine, HIV Infections, Costs and Cost Analysis, Health, HIV, Incidence, Health Personnel, Namibia, Combivir, economics, manpower
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TuOrC312