Return on Investment of HIV Care Within Universal Health Coverage in Low- and Middle-Income Countries: Evidence From...

HIV is a serious disease requiring long-term care and incurring high economic costs, particularly in low- and middle-income countries (LMICs). In Morocco, since 1998, the Ministry of Health has provided free care for people living with HIV, with financial support from the Global Fund. The study assessed the return on investment of providing HIV care as part of universal health coverage (UHC) financed by national health insurance in order to reduce dependence on international aid. We measured the benefit-cost ratio of the direct benefits and expected economic costs of HIV care under UHC between 2022 and 2025. We considered the essential HIV care package, which includes antiretroviral treatment, other medicines for some opportunistic infections, initial HIV testing, follow-up immunovirological tests, and medical visits. The total cost of HIV care as part of UHC between 2022 and 2025 was estimated at 1,036,675,480 Moroccan Dirhams (MAD). The monetary value gained as a result of the 4136 deaths avoided was estimated at 3,732,997,634 MAD. The return on investment was therefore estimated at 3.6 ≈ 4. This return on investment could be even higher, considering the indirect and/or social benefits. The provision of care and treatment to people living with HIV as part of UHC appears to be an efficient strategy in Morocco. This finding may inform UHC efforts in other LMICs.