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HIV/AIDS Treatment and Prevention in India

HIV/AIDS Treatment and Prevention in India

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How should governments respond to the increasing domestic and international pressures to finance antiretroviral therapy for AIDS patients? Once prohibitively expensive outside rich countries, antiretroviral therapy is now increasingly affordable, especially in India where patent laws and a dynamic pharmaceutical industry have facilitated the production and marketing of some of the best available drug combinations at prices below a dollar a day.

This title projects the future implications of three alternative AIDS treatment financing policies for the health burden of AIDS in India and for its overall health expenditures. The Indian government's 2004 treatment initiative contains elements of all three of these options. Written by an interdisciplinary team of AIDS experts, the book presents new data on the supply and demand for antiretroviral treatment in India and new models of the epidemiological effects and the financial costs of alternative policies. The book shows that the lower prices of antiretroviral therapy, plus the fact that therapy can reduce transmission by the treated patient, imply that such therapy could save healthy years of life at a cost of between $146 and $280 per year.

However, these conclusions depend on the assumption that treatment has no effect on risk behavior in key populations which account for most of the epidemic's spread. Sensitivity analysis reveals that multiplier effects due to behavioral responses would overwhelm the direct biological effects of treatment, leading the authors to recommend that India proceed cautiously. Careful monitoring of the population's response to treatment availability should suggest how to maximize the beneficial effects of treatment on risk behavior and to avoid the perverse effects.
How should governments respond to the increasing domestic and international pressures to finance antiretroviral therapy for AIDS patients? Once prohibitively expensive outside rich countries, antiretroviral therapy is now increasingly affordable, especially in India where patent laws and a dynamic pharmaceutical industry have facilitated the production and marketing of some of the best available drug combinations at prices below a dollar a day.

This title projects the future implications of three alternative AIDS treatment financing policies for the health burden of AIDS in India and for its overall health expenditures. The Indian government's 2004 treatment initiative contains elements of all three of these options. Written by an interdisciplinary team of AIDS experts, the book presents new data on the supply and demand for antiretroviral treatment in India and new models of the epidemiological effects and the financial costs of alternative policies. The book shows that the lower prices of antiretroviral therapy, plus the fact that therapy can reduce transmission by the treated patient, imply that such therapy could save healthy years of life at a cost of between $146 and $280 per year.

However, these conclusions depend on the assumption that treatment has no effect on risk behavior in key populations which account for most of the epidemic's spread. Sensitivity analysis reveals that multiplier effects due to behavioral responses would overwhelm the direct biological effects of treatment, leading the authors to recommend that India proceed cautiously. Careful monitoring of the population's response to treatment availability should suggest how to maximize the beneficial effects of treatment on risk behavior and to avoid the perverse effects.

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Publish date: Jun 23, 2004
Added to Scribd: May 09, 2014
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08/23/2014

 
Human Development Network 
Health, Nutrition, and Population Series
THE WORLD BANK
 Mead Over, Peter Heywood, Julian Gold, Indrani Gupta,Subhash Hira, Elliot Marseille
HIV/AIDS Treatment andPrevention in India
 Modeling the Cost and Consequences 
 
Selected titles from the World Bank’s Health, Nutrition,and Population Series:
Better Health Systems for India’s Poor: Findings, Analysis, and Options 
. 2002 (D. H. Peters, A. S. Yazbeck, R. R. Sharma, G. N. V. Ramana, L. H.Pritchett, and A. Wagstaff)
The Burden of Disease among the Global Poor: Current Situation, Future Trends,and Implications for Strategy
. 1999 (D. R. Gwatkin and M. Guillot)
Combating Malnutrition:Time to Act.
2003 (S. Gillespie, M. McLachlan, and R. Shrimpton, editors)
 Health Expenditures, Services, and Outcomes in Africa: Basic Data and Cross- National Comparisons, 1990-1996 
. 1999 (D. H. Peters, K. Kandola,  A. E. Elmendorf, and G. Chellaraj)
 Health, Nutrition, and Population Indicators: A Statistical Handbook
. 1998 (E. Bos, V. Hon, A. Maeda, G. Chellaraj, and A. S. Preker)
 Health Policy Research in South Asia:Building Capacity for Reform
. 2003 (A. S. Yazbeck and D. Peters, editors)
 HIV/AIDS in Latin American Countries:The Challenges Ahead.
2003 (Anabela Garcia Abreu, Isabel Noguer, and Karen Cowgill)
 Improving Women’s Health in Pakistan.
1998 (A. G. Tinker)
 Innovations in Health Service Delivery: The Corporatization of Public Hospitals.
2003 (A. S. Preker, A. Harding, editors)
 Investing in Maternal Health:Learning from Malaysia and Sri Lanka.
2003 (I. Pathmanathan, J. Liljestrand, J. M. Martins, L. C. Rajapaksa, C. Lissner, A. de Silva, S. Selvaraju, P. J. Singh)
 Measuring Country Performance on Health: Selected Indicators for 115 Countries 
.1999 (J. Wang, D. T. Jamison, E. Bos, A. S. Preker, and J. Peabody)
 Private Participation in Health Services 
. 2003(A. Harding and A. S. Preker, editors)
 Prospects for ImprovingNutrition in Eastern Europe and Central Asia
. 2002 (C. Rokx, R. Galloway, and L. Brown)
 Reducing Maternal Mortality:Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica, and Zimbabwe.
2003 (M. A. Koblinsky, editor)
 Reproductive Health in the Middle East and North Africa: Well-Being for All 
. 2001(A. Aoyama)
Social Re-Insurance: A New Approach to Sustainable Community Health Financing 
.2002 (D. Dror and A. S. Preker, editors)
Toward a Virtuous Circle: A Nutrition Review of the Middle East and North Africa
.1999 (A. Aoyama)
 
HIV/AIDS Treatment andPrevention in India
 Modeling the Costs and Consequences

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