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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Financing structural interventions: going beyond HIV-only value for money assessments.

Michelle Remme1, Anna Vassall, Brian Lutz

  • 1aLondon School of Hygiene and Tropical Medicine, London, UK bUnited Nations Development Programme, New York cColumbia University School of Public Health, New York, New York, USA.

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HIV structural interventions are undervalued with isolated budgeting. A cofinancing approach, integrating HIV and non-HIV sectors, maximizes benefits and improves resource allocation for better public health outcomes.

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Area of Science:

  • Public Health
  • Health Economics
  • Development Studies

Background:

  • Structural interventions are crucial for reducing HIV vulnerability.
  • HIV-specific budgeting may undervalue these interventions, leading to suboptimal resource allocation.
  • Examining alternative financing approaches is essential for effective investment.

Purpose of the Study:

  • To investigate the impact of different financing approaches on structural interventions.
  • To compare cross-sectoral cost-benefit analysis, siloed sector-specific analysis, and cofinancing.
  • To explore methods for determining HIV cost-sharing in cofinancing scenarios.

Main Methods:

  • Comparison of three financing approaches for a structural intervention in Malawi.
  • Cross-sectoral cost-benefit analysis involving HIV and non-HIV budget holders.
  • Sector-specific cost-effectiveness analysis and a cofinancing model with HIV cost allocation.

Main Results:

  • Isolated sector evaluations hinder prioritization and scaling of efficient structural interventions.
  • A cofinancing approach minimizes welfare loss and is suitable for sector budgeting.
  • Cofinancing enables simultaneous achievement of multiple health and development objectives.

Conclusions:

  • Structural interventions are at risk of underimplementation due to fragmented budgeting.
  • Cofinancing offers a viable strategy to achieve diverse public health and development goals.
  • Effective cross-sectoral coordination is vital for successful cofinancing and implementation.