This report uses a scenario planning approach to explore possible cost ranges for the introduction of future vaginal microbicides for the prevention of HIV transmission in the developing countries where clinical trials have been taking place. Three uptake scenarios (slow, medium and fast) for introduction and uptake volumes of a future microbicide over a 10-year period were derived from experiences of introducing female condoms and injectable contraceptives. The results vere very sensitive to the assumptions made about uptake, but the the baseline scenario suggested that microbicide programme costs might be of the order of $118m per annum by year 10 in the eight countries considered, and considerably higher if uptake is fast or the product is introduced in more countries or more areas of large countries. The key findings were as follows: it will take time to reach relatively modest coverage levels; product costs will represent a relatively large proportion of overall programme costs; there will be scope for continued subsidisation of product costs to ensure affordability for potential users; there will be a need to rely heavily on donor funding (at least in the initial stages of introduction); reliance on domestic government funding is likely to be more sustainable and predictable but it is not clear how realistic this might be; and the costs of introduction will merit early consideration of both the evidence base and the financing mechanisms that will be needed to support introduction, decision making and implementation.
Kumaranayake, L.; Pearson, M. Financing Mechanisms for Microbicide R&D and Future Introduction. (2007)