Table 2.
Summary of results from 23 allocative efficiency studies
| Key data | Optimization results under the current budget | Funding required for NSP targetsa | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Country | Yearb | Epidemic | PLHIVb | ART coverage (% of PLHIV) | Budget (US$m) | US$/PLHIV | Programme priority areas | Optimal ART coverage (% of PLHIV) | % reduction in infections | % reduction in deaths | Funds required as a % of current budget |
| Eastern Europe and Central Asia | |||||||||||
| Armenia | 2013 | Concentrated | 3600 | 65% | 4.5 | 1259 |
↑ Scale‐up ART, OST, programmes for PWID & FSW – Maintain PMTCT, programmes for prisoners & PWID ↓ Scale‐down GP programmes (SBCC, HTC) |
94% | 17%c | 29%c | 265% |
| Belarus | 2013 | Concentrated | 35,000 | 32% | 20.5 | 586 |
↑ Scale‐up ART, OST, programmes for PWID – Maintain PMTCT, programmes for FSW & MSM ↓ Scale‐down GP programmes (SBCC, HTC) |
46% | 7%c | 25%c | 125% |
| Bulgaria | 2014 | Concentrated | 6000 | 21% | 8.6 | 1437 |
↑ Scale‐up OST, programmes for PWID, MSM & prisoners – Maintain ART, programmes for FSW ↓ Scale‐down GP programmes (SCCC, HTS) |
21% | 21%d | 7%d | 264% |
| Georgia | 2014 | Concentrated | 8900 | 32% | 14.7 | 1657 |
↑ Scale‐up ART, HTC for KPs, programmes for MSM – Maintain programmes for PWID & FSW, OST (60%) ↓ Scale‐down GP programmes (HTC) |
59% | 16%d | 36%d | 140% |
| Kazakhstan | 2013 | Concentrated | 23,000 | 22% | 34.0 | 1478 |
↑ Scale‐up ART, HTC, programmes for PWID & MSM – Maintain PMTCT, programmes for FSW ↓ Scale‐down GP programmes (SBCC, HTC) |
30% | 6%c | 22%c | 137% |
| Kyrgyz Republic | 2013 | Concentrated | 7500 | 13% | 16.0 | 2130 |
↑ Scale‐up ART, HTC, programmes for PWID & MSM – Maintain PMTCT, OST, programmes for FSW |
41% | 28%c | 53%c | 190% |
| Macedonia | 2013 | Concentrated | 900 | 22% | 6.5 | 7209 |
↑ Scale‐up ART, HTS for KPs, programmes for MSM – Maintain programmes for PWID (NSP, OST) & FSW ↓ Scale‐down GP programmes (SBCC) |
63% | 85%d | 87%d | 100% |
| Moldova | 2013 | Concentrated | 15,000 | 24% | 0.8 | 51 |
↑ Scale‐up ART, programmes for FSW, PWID & MSM – Maintain PMTCT ↓ Scale‐down GP programmes (condoms, HTC) |
38% | 20%c | 16%c | 233% |
| Tajikistan | 2013 | Concentrated | 15,000 | 10% | 14.1 | 940 |
↑ Scale‐up ART, all KP programmes – Maintain HTC, PMTCT ↓ Scale‐down Youth, community mobilization, SBCC |
15% | 5%c | Not incl. | Not incl. |
| Ukraine | 2013 | Concentrated | 210,000 | 30% | 85.2 | 406 |
↑ Scale‐up ART, lab monitoring – Maintain all KP programmes, PMTCT ↓ Scale‐down GP programmes (HTC) |
41% | 3%c | 9%c | Not incl. |
| Uzbekistan | 2011 to 2012 | Concentrated | 42,000 | 16% | 21.1 | 502 |
↑ Scale‐up ART, HTC – Maintain all other prevention ↓ Scale‐down youth programmes |
17% | 44%c | Not incl. | Not incl. |
| Latin America and the Caribbean | |||||||||||
| Argentina | 2012 | Concentrated | 100,000 | 41% | 501.9 | 5020 | – Maintain response | 41% | 0%d | 0%d | Not incl. |
| Colombia | 2012 | Concentrated | 130,000 | 45% | 60.0 | 545 |
↑ Scale‐up ART, programmes for MSM & homeless ↓ Scale‐down GP programmes (HTC) |
53% | 28%d | 24%d | Not incl. |
| Mexico | 2011 | Concentrated | 170,000 | 52% | 432.4 | 2298.5 |
↑ Scale‐up ART – Maintain PMTCT ↓ Scale‐down GP programmes |
56% | 4%d | 7%d | 125% |
| Peru | 2014 | Concentrated | 88,000 | 57% | 91.8 | 1044 |
↑ Scale‐up ART – Maintain PMTCT ↓ Scale‐down GP programmes (condoms, SBCC, HTC) |
57% | 38%d | 33%d | Not incl. |
| Sub‐Saharan Africa | |||||||||||
| Zambia | 2012 | Mixed | 1,100,000 | 55% | 284.2 | 258 |
↑ Scale‐up ART, programmes for FSW – Maintain PMTCT ↓ Scale‐down HTC, GP programmes |
60% | 5%d | 36%d | 133% |
| East Asia and the Pacific | |||||||||||
| Indonesia | 2012 | Mixed | 590,000 | 9% | 87.0 | 147 |
↑ Scale‐up OST, programmes for PWID, MSM, FSW ↓ Scale‐down GP programmes (condoms, SBCC, HTC) |
Not incl.e | 5%c | 2%c | Not incl. |
| Vietnam | 2012 | Concentrated | 250,000 | Not incl. | 136.1 | 544 |
↑ Scale‐up HTC, programmes for FSW, MSM ↓ Scale‐down GP programmes, NSP, OST, STI programmes |
Not incl.e | 16%f | 1%f | Not incl. |
| West and Central Africa | |||||||||||
| Cote d'Ivoire | 2013 | Mixed | 470,000 | 29% | 106.0 | 226 |
↑ Scale‐up ART, HTC, FSW programmes ↓ Scale‐down GP programmes (condoms, HTC) |
32% | 5%c | 6%c | 283% |
| Niger | 2012 | Concentrated | 54,000 | 24% | 16.1 | 298 |
↑ Scale‐up ART, PMTCT, FSW programmes – Maintain programmes for prisoners, migrants, MSM, mine workers, truckers, OVC, PEP ↓ Scale‐down GP programmes |
43% | 30%g | 19%g | Not incl. |
| Senegal | 2013 | Concentrated | 48,000 | 33% | 24.3 | 505 |
↑ Scale‐up ART, PMTCT, programmes for FSW & MSM ↓ Scale‐down GP programmes (HTC, SBCC) |
50% | 31%c | 28%c | Not incl. |
| Sudan | 2013 | Concentrated | 56,000 | 6% | 12.3 | 220 |
↑ Scale‐up ART, programmes for FSW & clients & MSM ↓ Scale‐down GP programmes |
12% | 36%c | Not incl. | 134% |
| Togo | 2014 | Mixed | 110,000 | 31% | 20.1 | 183 | – Maintain response | 31% | 0%g | 0%g | 155% |
| Averages | |||||||||||
| 30% | 1285 | 42% |
18% to 2020 25% to 2030 |
22% to 2020 29% to 2030 |
176% | ||||||
ART, antiretroviral therapy; OST, opiate substitution therapy; PWID, people who inject drugs; FSW, female sex workers; PMTCT, prevention of mother‐to‐child transmission; MSM, men who have sex with men; GP, general population; SBCC, social and behaviour change communication; HTC, HIV testing and counselling; OVC, orphans and vulnerable children; KP, key population; VL, viral load; PEP, post‐exposure prophylaxis; Not incl., indicator not requested for this study.
Percentage increase over the total expenditure at the last NASA that would be required to meet the National Strategic Plan (NSP) targets, assuming that funds were optimally allocated.
Year for which latest National AIDS Spending Accounts were available at the time study was conducted, and estimate of the number of PLHIV in that year as published in the country reports.
Percentage reduction in cumulative infections/deaths over the years until 2020 that could be obtained via optimally allocating resources.
Percentage reduction in cumulative infections/deaths over the years until 2030 that could be obtained via optimally allocating resources.
In Vietnam, and Indonesia, ART was not considered as part of the pool of funding available for reallocation but rather as required resources earmarked as an essential expense. Therefore, we did not estimate optimal coverage levels for these two countries.
Percentage reduction in cumulative infections/deaths over 2006 to 2010 that could be obtained via optimally allocating resources.
Percentage reduction in cumulative infections/deaths over the years until 2025 that could be obtained via optimally allocating resources.