15th International AIDS Conference Bangkok, Thailand — July 11-July 16, 2004

Int Conf AIDS. 2004 Jul 11-16;15:Abstract No. LbOrE40

O Smith, G Kombe
Abt Associates, Inc., Bethesda, MD, United States

BACKGROUND: The president's emergency plan for AIDS relief (PEPFAR) pledges $15 billion over 5 years towards the fight against HIV/AIDS. Among the plan's goals is to provide anti-retroviral (ARV) treatment to 2 million patients. The opportunities and constraints of the plan with regard to resource allocation is a key issue for study.

METHODS: The paper analyzes the feasibility of the treatment goals set forth in the February 2004 PEPFAR document in terms of resource requirements. The modeling exercise considers all major inputs and key supporting services, and makes use of epidemiological and cost data drawn from international sources and field visits to a subset of PEPFAR countries. This paper is the companion piece to the analysis of PEPFAR objectives for prevention and mitigation using the GOALS model, submitted to the same session by Acharya, Clark, and Forsythe.

RESULTS: The goal of treating 2 million people by 2008 can be easily achieved within the allocated budget under a scenario of relatively low ARV drug costs ($300 per patient per year for adults on first line). In the case of high drug costs, however, reaching the target will be more difficult. In addition, there are other potential obstacles to achieving the PEPFAR objectives beyond the purely financial issue. The paper also quantifies human resource requirements and uptake rates for voluntary counseling and testing (VCT) implied by the PEPFAR treatment goals. Results indicate that in certain countries the human resource and VCT uptake constraints may be more important than the financial one.

CONCLUSIONS: It is feasible to achieve the treatment goals established by PEPFAR within the allocated budget if ARV drug costs are not high. However success is not guaranteed, as non-financial barriers such as human resources and VCT uptake are important as well. The results can help inform a range of policy decisions and ensure that the maximum benefit is achieved with PEPFAR resources.

040711
LbOrE40

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