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Delivering pediatric HIV care in resource-limited settings: cost considerations in an expanded response
Michael A Tolle1, B Ryan Phelps, Chris Desmond
1aBaylor College of Medicine Children's Foundation - Tanzania, Bugando Medical Centre, Mwanza, Tanzania bUnited States Agency for International Development, Washington, DC, USA cDevelopment Pathways to Health Research Unit, University of Witwatersrand, Johannesburg dClinton Health Access Initiative eUnited Nations Children's Fund (UNICEF), New York, New York fPartnership for Supply Chain Management, Arlington, Virginia, USA gBaylor College of Medicine Children's Foundation-Malawi, Kamuzu Central Hospital, Lilongwe, Malawi hWorld Health Organization, Geneva, Switzerland iManagement Sciences for Health, Cambridge, Massachusetts, USA.
Insights
Expanding pediatric HIV treatment is crucial alongside prevention of mother-to-child transmission (PMTCT) programs. Prioritizing efficient interventions for HIV-infected children ensures better resource allocation and saves lives.
Area of Science:
- Public Health
- Pediatric Infectious Diseases
- Health Economics
Background:
- Protection of children from HIV requires integrating prevention of mother-to-child transmission (PMTCT) with expanded pediatric treatment.
- Treating HIV-infected children is ethically imperative, despite high costs, due to humanitarian, equity, and children's rights considerations.
- Inefficiencies in resource allocation within limited budgets can lead to reduced service coverage and effectiveness, impacting children's lives.
Purpose of the Study:
- To review cost drivers in pediatric HIV interventions.
- To identify strategies for enhancing efficiency in pediatric HIV programming.
- To inform the design and scale-up of cost-effective pediatric HIV treatment programs.
Main Methods:
- Literature review of existing knowledge on cost drivers in pediatric HIV interventions.
- Analysis of high-impact interventions with disproportional returns on investment.
- Formulation of recommendations for improving efficiency in pediatric HIV programming.
Main Results:
- Identification of key cost drivers influencing the provision of pediatric HIV treatment.
- Highlighting of specific high-impact interventions that offer significant returns on investment.
- Development of strategies to optimize resource utilization for treating HIV-infected children.
Conclusions:
- Efficient pediatric HIV treatment programs are essential for maximizing the impact of available resources.
- Prioritizing and scaling up high-impact interventions can improve outcomes for HIV-infected children.
- Sustained progress towards universal access requires increased funding and better data on intervention costs and outcomes.
Abstract:
If children are to be protected from HIV, the expansion of PMTCT programs must be complemented by increased provision of paediatric treatment. This is expensive, yet there are humanitarian, equity and children's rights arguments to justify the prioritization of treating HIV-infected children. In the context of limited budgets, inefficiencies cost lives, either through lower coverage or less effective services. With the goal of informing the design and expansion of efficient paediatric treatment programs able to utilize to greatest effect the available resources allocated to the treatment of HIV-infected children, this article reviews what is known about cost drivers in paediatric HIV interventions, and makes suggestions for improving efficiency in paediatric HIV programming. High-impact interventions known to deliver disproportional returns on investment are highlighted and targeted for immediate scale-up. Progress will carry a cost - increased funding, as well as additional data on intervention costs and outcomes, will be required if universal access of HIV-infected children to treatment is to be achieved and sustained.
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