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.
A systematic review was undertaken using databases and consultations with experts. Over 60 reports were identified that measured both the cost and effectiveness of HIV/AIDS interventions in Africa. 24 studies met the 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.
The Lancet (2002) 359 (9318) 1635-1642 [doi:10.1016/S0140-6736(02)08595-1]