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Cited by 394HIV/AIDS Research and InterventionsHIV/AIDS Impact and ResponsesHealth Systems, Economic Evaluations, Quality of Life

The DOI matches its Crossref record; 41 of the 42 references it cites were found in a registry or an index.

Cost-effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence

Creese, Andrew, Floyd, Katherine, Alban, Anita, Guinness, Lorna·2002·The Lancet
DOI 10.1016/s0140-6736(02)08595-1
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Abstract

Background Evidence for cost-effectiveness of interventions for HIV/AIDS in Africa is fragmentary. Cost-effectiveness is, however, highly relevant. African governments face difficult choices in striking the right balance between prevention, treatment, and care, all of which are necessary to deal comprehensively with the epidemic. Reductions in drug prices have raised the priority of treatment, though treatment access is restricted. We assessed the existing cost-effectiveness data and its implications for value-for-money strategies to combat HIV/AIDS in Africa. Methods We undertook a systematic review using databases and consultations with experts. We identified over 60 reports that measured both the cost and effectiveness of HIV/AIDS interventions in Africa. 24 studies met our inclusion criteria and were used to calculate standardised estimates of the cost (US$ for year 2000) per HIV infection prevented and per disability-adjusted life-year (DALY) gained for 31 interventions. Findings Cost-effectiveness varied greatly between interventions. A case of HIV/AIDS can be prevented for $11, and a DALY gained for $1, by selective blood safety measures, and by targeted condom distribution with treatment of sexually transmitted diseases. Single-dose nevirapine and short-course zidovudine for prevention of mother-to-child transmission, voluntary counselling and testing, and tuberculosis treatment, cost under $75 per DALY gained. Other interventions, such as formula feeding for infants, home care programmes, and antiretroviral therapy for adults, cost several thousand dollars per infection prevented, or several hundreds of dollars per DALY gained. Interpretation A strong economic case exists for prioritisation of preventive interventions and tuberculosis treatment. Where potentially exclusive alternatives exist, cost-effectiveness analysis points to an intervention that offers the best value for money. Cost-effectiveness analysis is an essential component of informed debate about priority setting for HIV/AIDS.

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Crossref · 10.1016/s0140-6736(02)08595-1

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Metadata

Authors
Creese, A., Floyd, K., Alban, A., & Guinness, L.
Affiliations
  • World Health Organization (CH)
  • University of Copenhagen (DK)
  • London School of Hygiene & Tropical Medicine (GB)
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2002-05
Volume
359
Issue
9318
Pages
1635-1642
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(02)08595-1
OpenAlex
W2124497469
Cited by
394
References
42
Citations by year
2025: 5 · 2024: 6 · 2023: 5 · 2022: 2 · 2021: 9 · 2020: 7 · 2019: 10 · 2018: 8 · 2017: 8 · 2016: 8 · 2015: 9 · 2014: 13 · 2013: 14 · 2012: 10
FWCI
6.01
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › HIV/AIDS Impact and Responses
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
HIV/AIDS, cost-effectiveness, HIV prevention, antiretroviral therapy, prevention of mother-to-child transmission, tuberculosis treatment, transfusion safety, condom distribution, sexually transmitted infections, voluntary counseling and testing, disability-adjusted life years, priority setting, resource allocation, Africa
MeSH terms
Acquired Immunodeficiency Syndrome, Africa, Cost-Benefit Analysis, Female, Health Priorities, Humans, Male, Tuberculosis, HIV Infections, AIDS-Related Opportunistic Infections, Quality-Adjusted Life Years, Anti-HIV Agents

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