Getting it right when budgets are tight: Using optimal expansion pathways to prioritize responses to concentrated and mixed HIV epidemics.

Stuart, RM; Kerr, CC; Haghparast-Bidgoli, H; Estill, J; Grobicki, L; Baranczuk, Z; Prieto, L; Montañez, V; Reporter, I; Gray, RT; Skordis-Worrall, J; Keiser, O; Cheikh, N; Boonto, K; Osornprasop, S; Lavadenz, F; Benedikt, CJ; Martin-Hughes, R; Hussain, SA; Kelly, SL; Kedziora, DJ; Wilson, DP

Getting it right when budgets are tight: Using optimal expansion pathways to prioritize responses to concentrated and mixed HIV epidemics.

Stuart, RM Kerr, CC Haghparast-Bidgoli, H Estill, J Grobicki, L Baranczuk, Z Prieto, L Montañez, V Reporter, I Gray, RT Skordis-Worrall, J Keiser, O Cheikh, N Boonto, K Osornprasop, S Lavadenz, F Benedikt, CJ Martin-Hughes, R Hussain, SA Kelly, SL Kedziora, DJ Wilson, DP

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Publisher:: Public Library of Science (PLoS)
Publication Type:: Journal Article
Citation:: PLoS One, 2017, 12, (10), pp. 1-13
Issue Date:: 2017

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Field	Value	Language
dc.contributor.author	Stuart, RM
dc.contributor.author	Kerr, CC
dc.contributor.author	Haghparast-Bidgoli, H
dc.contributor.author	Estill, J
dc.contributor.author	Grobicki, L
dc.contributor.author	Baranczuk, Z
dc.contributor.author	Prieto, L
dc.contributor.author	Montañez, V
dc.contributor.author	Reporter, I
dc.contributor.author	Gray, RT
dc.contributor.author	Skordis-Worrall, J
dc.contributor.author	Keiser, O
dc.contributor.author	Cheikh, N
dc.contributor.author	Boonto, K
dc.contributor.author	Osornprasop, S
dc.contributor.author	Lavadenz, F
dc.contributor.author	Benedikt, CJ
dc.contributor.author	Martin-Hughes, R
dc.contributor.author	Hussain, SA
dc.contributor.author	Kelly, SL
dc.contributor.author	Kedziora, DJ
dc.contributor.author	Wilson, DP
dc.date.accessioned	2022-07-14T05:39:21Z
dc.date.available	2017-09-06
dc.date.available	2022-07-14T05:39:21Z
dc.date.issued	2017
dc.identifier.citation	PLoS One, 2017, 12, (10), pp. 1-13
dc.identifier.issn	1932-6203
dc.identifier.issn	1932-6203
dc.identifier.uri	http://hdl.handle.net/10453/158911
dc.description.abstract	BACKGROUND: Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and epidemiological outcomes. It can be difficult for countries to know which interventions to prioritize for greatest epidemiological impact, particularly when budgets are uncertain. METHODS: We examined four case studies of HIV epidemics in diverse settings, each with different characteristics. These case studies were based on public data available for Belarus, Peru, Togo, and Myanmar. The Optima HIV model and software package was used to estimate the optimal distribution of resources across interventions associated with a range of budget envelopes. We constructed "investment staircases", a useful tool for understanding investment priorities. These were used to estimate the best attainable cost-effectiveness of the response at each investment level. FINDINGS: We find that when budgets are very limited, the optimal HIV response consists of a smaller number of 'core' interventions. As budgets increase, those core interventions should first be scaled up, and then new interventions introduced. We estimate that the cost-effectiveness of HIV programming decreases as investment levels increase, but that the overall cost-effectiveness remains below GDP per capita. SIGNIFICANCE: It is important for HIV programming to respond effectively to the overall level of funding availability. The analytic tools presented here can help to guide program planners understand the most cost-effective HIV responses and plan for an uncertain future.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	Public Library of Science (PLoS)
dc.relation.ispartof	PLoS One
dc.relation.isbasedon	10.1371/journal.pone.0185077
dc.rights	info:eu-repo/semantics/openAccess
dc.rights	Copyright: © 2017 Stuart et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.subject.classification	General Science & Technology
dc.subject.mesh	Budgets
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Health Priorities
dc.subject.mesh	HIV Infections
dc.subject.mesh	Humans
dc.subject.mesh	Budgets
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	HIV Infections
dc.subject.mesh	Health Priorities
dc.subject.mesh	Humans
dc.subject.mesh	Humans
dc.subject.mesh	HIV Infections
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Budgets
dc.subject.mesh	Health Priorities
dc.title	Getting it right when budgets are tight: Using optimal expansion pathways to prioritize responses to concentrated and mixed HIV epidemics.
dc.type	Journal Article
utslib.citation.volume	12
utslib.location.activity	United States
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Strength - AAI - Advanced Analytics Institute Research Centre
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-07-14T05:39:17Z
pubs.issue	10
pubs.publication-status	Published
pubs.volume	12
utslib.citation.issue	10

Abstract:

BACKGROUND: Prioritizing investments across health interventions is complicated by the nonlinear relationship between intervention coverage and epidemiological outcomes. It can be difficult for countries to know which interventions to prioritize for greatest epidemiological impact, particularly when budgets are uncertain. METHODS: We examined four case studies of HIV epidemics in diverse settings, each with different characteristics. These case studies were based on public data available for Belarus, Peru, Togo, and Myanmar. The Optima HIV model and software package was used to estimate the optimal distribution of resources across interventions associated with a range of budget envelopes. We constructed "investment staircases", a useful tool for understanding investment priorities. These were used to estimate the best attainable cost-effectiveness of the response at each investment level. FINDINGS: We find that when budgets are very limited, the optimal HIV response consists of a smaller number of 'core' interventions. As budgets increase, those core interventions should first be scaled up, and then new interventions introduced. We estimate that the cost-effectiveness of HIV programming decreases as investment levels increase, but that the overall cost-effectiveness remains below GDP per capita. SIGNIFICANCE: It is important for HIV programming to respond effectively to the overall level of funding availability. The analytic tools presented here can help to guide program planners understand the most cost-effective HIV responses and plan for an uncertain future.

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http://hdl.handle.net/10453/158911