Towards an improved investment approach for an effective response to HIV/AIDS

B Schwartländer, J Stover, T Hallett, R Atun, C Avila, E Gouws, M Bartos, PD Ghys, M Opuni, D Barr, R Alsallaq, L Bollinger, M de Freitas, G Garnett, C Holmes, K Legins, Y Pillay, AE Stanciole, C McClure, G HirnschallM Laga, N Padian

    Research output: Contribution to journalA1: Web of Science-articlepeer-review


    Substantial changes are needed to achieve a more targeted and strategic approach to investment in the response to the HIV/AIDS epidemic that will yield long-term dividends. Until now, advocacy for resources has been done on the basis of a commodity approach that encouraged scaling up of numerous strategies in parallel, irrespective of their relative effects. We propose a strategic investment framework that is intended to support better management of national and international HIV/AIDS responses than exists with the present system. Our framework incorporates major efficiency gains through community mobilisation, synergies between programme elements, and benefits of the extension of antiretroviral therapy for prevention of HIV transmission. It proposes three categories of investment, consisting of six basic programmatic activities, interventions that create an enabling environment to achieve maximum effectiveness, and programmatic efforts in other health and development sectors related to HIV/AIDS. The yearly cost of achievement of universal access to HIV prevention, treatment, care, and support by 2015 is estimated at no less than US$22 billion. Implementation of the new investment framework would avert 12.2 million new HIV infections and 7.4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches, and result in 29.4 million life-years gained. The framework is cost effective at $1060 per life-year gained, and the additional investment proposed would be largely offset from savings in treatment costs alone.
    Original languageEnglish
    Issue number9782
    Pages (from-to)2031-2041
    Number of pages11
    Publication statusPublished - 2011


    • B780-tropical-medicine
    • Viral diseases
    • HIV
    • AIDS
    • Epidemics
    • Control strategies
    • Financing
    • Resource mobilization
    • Advocacy
    • Targeted approach
    • Framework
    • Modeling
    • Prevention
    • Efficiency
    • Community mobilization
    • Control programs
    • HAART
    • Antiretrovirals
    • Interventions
    • Effectiveness
    • Universal coverage
    • Accessibility
    • Cost
    • Cost-effectiveness
    • Review of the literature
    • Global


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