1 / 10

Resource requirements for reaching the treatment goals under PEPFAR

Resource requirements for reaching the treatment goals under PEPFAR. XV International AIDS Conference Bangkok July 15, 2004 Owen Smith, Abt Associates Inc. Gilbert Kombe, Abt Associates Inc. Introduction and Objectives. The President’s Emergency Plan for AIDS Relief (PEPFAR):

ondrea
Download Presentation

Resource requirements for reaching the treatment goals under PEPFAR

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Resource requirements for reaching the treatment goals under PEPFAR XV International AIDS Conference Bangkok July 15, 2004 Owen Smith, Abt Associates Inc. Gilbert Kombe, Abt Associates Inc.

  2. Introduction and Objectives • The President’s Emergency Plan for AIDS Relief (PEPFAR): • PEPFAR targets • Treat 2 million people with ARVs by 2008 • Prevent 7 million new infections by 2008 • Provide care to 10 million individuals by 2008 • Budget of $15 billion • $10 billion of this is new money, of which $1 billion is for the Global Fund; 55% of the remainder is ear-marked for treatment • Key questions for study: • Is the budget adequate for achieving the stated targets? • What are the human resource requirements? • Findings can help inform policy decisions

  3. Assumptions and Methods • Assumed the goal of reaching 2 million on ARVs by 2008 is achieved in equal steps each year, starting in 2004 • Calculations include drugs, monitoring tests, labor, training, and capital • The cost of key supporting services is also included: voluntary counseling and testing (VCT) and treatment of opportunistic infections (OIs) • Some pediatric and 2nd line treatment included • Data was collected through primary sources in Uganda and Zambia, interviews with providers, and from international sources

  4. Methods (continued) • Per patient results indicate that drugs and monitoring tests account for most costs; labor, training, and capital costs were small in comparison • Therefore explored two scenarios: • Low drug costs ($300 per patient on 1st line per year) • High drug costs ($600 per patient on 1st line per year)

  5. Reaching targets within PEPFAR budgetNumber of ARV patients under low and high drug cost scenarios

  6. Human resource requirements • As drug prices fall and donor funding rises, there is increased focus on other potential obstacles to expansion • Quantifying financial needs is done frequently; quantifying human resource needs is much less common • Explore two scenarios for the number of doctors required to provide ARVs: • 90 minutes of doctor time per ARV patient per year • 45 minutes of doctor time per ARV patient per year

  7. Human resource requirementsShare of doctor workforce required to achieve PEPFAR goals

  8. Human resource requirementsShare of doctor workforce required to reach full coverage by 2013

  9. Conclusions • Drug prices will be an important determinant of the feasibility of reaching PEPFAR goals within the budget • The human resource constraint could be more important in certain countries than the financial constraint; pursuing the many options for improving HR capacity should be an urgent priority • Key uncertainties in ARV costing: • Drug prices • Rate of attrition to second line treatment • Uptake of VCT services in a large-scale ARV program setting • OI costs: reduced or delayed? • Impact of ARV expansion on prevention efforts (long-term)

  10. Thank you • Partners for Health Reformplus project • USAID • Office of the Global AIDS Coordinator • Institute of Medicine (U.S.) • POLICY project

More Related