Scaling-up HIV interventions in India
Scaling-up HIV prevention interventions has been recognised as an urgent need in India but little empirical data are available on the costs that would be associated with this. India’s National AIDS Control Programme will significantly enhance prevention activities in the country and for this reason local data on cost, quality and trends is needed to ensure the best possible allocation of resources.
"We studied changes in unit costs of two major interventions over a period of time," said author Professor Lalit Dandona, Director of The George Institute, India. This included representative samples of public-funded VCT (voluntary counselling and testing) centres and sex worker programs in Andhra Pradesh, India. Professor Dandona and colleagues assessed over a period of three years how the economic cost of providing VCT and sex worker interventions changed in Andhra Pradesh, the Indian state with India’s highest burden of HIV.
"Local data are vital for policy makers to make the best possible decisions on resource allocation," said Professor Dandona. "We found that the unit cost for providing VCT to each client halved over three years due to a large increase in clients served without any indication of associated compromise in quality of services, indicating under-utilised capacity in the early stage that was utilised in the later stage. On the other hands, the unit cost of providing HIV prevention services to sex workers more than doubled over a three year period largely due to improvements in the quality of these services. These local longitudinal cost data should be useful to inform the currently planned scaling up of HIV interventions in India," said Professor Dandona.
Using HIV research findings to improve interventions
Professor Dandona was recently invited to speak at the XVII International AIDS Conference in Mexico City on ‘Epidemiology estimates of HIV: how accurate and useful are they?’. The talk was based on data from this and other HIV studies conducted by Professor Dandona and his team in India in addition to the recent National Family Health Survey.
Professor Dandona discussed how to better use scientific epidemiological principles to design HIV studies in India and interpret data from them and how to more systematically utilise this information to improve HIV control interventions. He said "There is much global interest in better understanding HIV in India as until recently scientifically sound data have been mostly coming from sub-Saharan Africa." The George Institute India is involved with a variety of scientific studies to contribute to the evidence base needed for effective control of HIV in India.