The cost-effectiveness of HIV programmes targeting injecting drug users in west Sumatera, Indonesia
Document type: mthesis
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Abstract:
BACKGROUND: Injecting drug use has been a major driver of the HIV epidemic in West Sumatera Province, Indonesia. HIV programme intervention is urgently required to prevent further spread of HIV. The Indonesian Harm Reduction policy was issued in 2007 recommending the implementation of a comprehensive programme targeting injecting drug users which includes prevention measures, care and treatment. Although it is recommended by the National AIDS Commission to set the coverage target at 80% coverage, there is little evidence on the required level of HIV programme coverage targeting injecting drug users to substantially avert new infections within the limited amount of resources. OBJECTIVES: To undertake a cost-effectiveness analysis to find the most cost-effective level of coverage from four levels of coverage: 20%, 40%, 60% and 80% of the comprehensive programme. METHODS: Two linked models, the Asian Epidemic Model and the Resource Needs Model, are used to generate both cost required for a certain level of coverage and new infections averted for each level of coverage, compared to the baseline (no intervention) scenario. Cost and averted infections data are applied to generate cost-effectiveness ratios. RESULTS: The 40% programme coverage is the most cost-effective coverage level, with a cost effectiveness ratio equal to US$1,016 per HIV infection averted over a period of five years. DISCUSSION & RECOMMENDATION: Although 40% level of coverage is the most cost-effective level of coverage, 80% coverage is needed to achieve universal access if the resources are available. Setting an ambitious coverage is also recommended, as the increase of HIV prevalence among IDU will cause proliferation of HIV to the general population, making it harder to control in the future. The priority action is to implement the comprehensive programme as soon as possible, mainly because West Sumatera has reached an advanced stage of HIV epidemic. Political commitment and strengthening support system such as the health system, human resources and institutional management, are vital to ensure the attainment of programme coverage and quality programme implementation.
Authors:
Indrasari, W.
Country:
Indonesia
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
HIV and AIDS
,
disease prevention and control
,
health services
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
52
Year:
2009
Region:
Southeast Asia
Right:
© 2009 Indrasari
Subject:
Health and Nutrition
Title:
The cost-effectiveness of HIV programmes targeting injecting drug users in west Sumatera, Indonesia
Training:
Master of Public Health / International Course in Health Development (ICHD)