Wu Zeng1, Donald S Shepard2, Carlos Avila-Figueroa3, Haksoon Ahn4. 1. Schneider Institutes for Health Policy, Heller School, MS 035, Brandeis University, Waltham, MA 02454, USA, wuzengcn@brandeis.edu. 2. Schneider Institutes for Health Policy, Heller School, MS 035, Brandeis University, Waltham, MA 02454, USA. 3. Abt Associates, Bethesda, MD 20814, USA and. 4. School of Social Work, University of Maryland, Baltimore, MD 21201, USA.
Abstract
BACKGROUND: -To manage the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic, international donors have pledged unprecedented commitments for needed services. The Joint United Nations Programme on HIV/AIDS (UNAIDS) projected that low- and middle-income countries needed $25 billion to meet the 2010 HIV/AIDS goal of universal access to AIDS prevention and care, using the resource needs model (RNM). METHODS: -Drawing from the results from its sister study, which used a data envelopment analysis (DEA) and a Tobit model to evaluate and adjust the technical efficiency of 61 countries in delivering HIV/AIDS services from 2002 to 2007, this study extended the DEA and developed an approach to estimate resource needs and decompose the performance gap into efficiency gap and resource gap. In the DEA, we considered national HIV/AIDS spending as the input and volume of voluntary counseling and testing (VCT), prevention of mother to child transmission (PMTCT) and antiretroviral treatment (ART) as the outputs. An input-oriented DEA model was constructed to project resource needs in achieving 2010 HIV/AIDS goal for 45 countries using the data in 2006, assuming that all study countries maximized efficiency. FINDINGS: -The DEA approach demonstrated the potential to include efficiency of national HIV/AIDS programmes in resource needs estimation, using macro-level data. Under maximal efficiency, the annual projected resource needs for the 45 countries was $6.3 billion, ∼47% of their UNAIDS estimate of $13.5 billion. Given study countries' spending of $3.9 billion, improving efficiency could narrow the gap from $9.6 to $2.4 billion. The results suggest that along with continued financial commitment to HIV/AIDS, improving the efficiency of HIV/AIDS programmes would accelerate the pace to reach 2010 HIV/AIDS goals. The DEA approach provides a supplement to the AIDS RNM to inform policy making.
BACKGROUND: -To manage the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) epidemic, international donors have pledged unprecedented commitments for needed services. The Joint United Nations Programme on HIV/AIDS (UNAIDS) projected that low- and middle-income countries needed $25 billion to meet the 2010 HIV/AIDS goal of universal access to AIDS prevention and care, using the resource needs model (RNM). METHODS: -Drawing from the results from its sister study, which used a data envelopment analysis (DEA) and a Tobit model to evaluate and adjust the technical efficiency of 61 countries in delivering HIV/AIDS services from 2002 to 2007, this study extended the DEA and developed an approach to estimate resource needs and decompose the performance gap into efficiency gap and resource gap. In the DEA, we considered national HIV/AIDS spending as the input and volume of voluntary counseling and testing (VCT), prevention of mother to child transmission (PMTCT) and antiretroviral treatment (ART) as the outputs. An input-oriented DEA model was constructed to project resource needs in achieving 2010 HIV/AIDS goal for 45 countries using the data in 2006, assuming that all study countries maximized efficiency. FINDINGS: -The DEA approach demonstrated the potential to include efficiency of national HIV/AIDS programmes in resource needs estimation, using macro-level data. Under maximal efficiency, the annual projected resource needs for the 45 countries was $6.3 billion, ∼47% of their UNAIDS estimate of $13.5 billion. Given study countries' spending of $3.9 billion, improving efficiency could narrow the gap from $9.6 to $2.4 billion. The results suggest that along with continued financial commitment to HIV/AIDS, improving the efficiency of HIV/AIDS programmes would accelerate the pace to reach 2010 HIV/AIDS goals. The DEA approach provides a supplement to the AIDS RNM to inform policy making.
Authors: Lario Viljoen; Tila Mainga; Rozanne Casper; Constance Mubekapi-Musadaidzwa; Dillon T Wademan; Virginia A Bond; Triantafyllos Pliakas; Chiti Bwalya; Anne Stangl; Mwelwa Phiri; Blia Yang; Kwame Shanaube; Peter Bock; Sarah Fidler; Richard Hayes; Helen Ayles; James R Hargreaves; Graeme Hoddinott; J Seeley; D Donnell; S Floyd; N Mandla; J Bwalya; K Sabapathy; S H Eshleman; D Macleod; A Moore; S H Vermund; K Hauck; K Shanaube Journal: Health Policy Plan Date: 2021-06-25 Impact factor: 3.344
Authors: Wu Zeng; Anita Musiega; Joyce Oyasi; Laura Di Giorgio; Jane Chuma; Ruoyan Lu; Haksoon Ahn Journal: Health Policy Plan Date: 2022-02-08 Impact factor: 3.547