The economic returns of ending the AIDS epidemic as a public health threat

• Published in: Health policy (Amsterdam) 2019-01, Vol.123 (1), p.104-108
• Main Authors: Lamontagne, Erik, Over, Mead, Stover, John
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Ambition; Comparative studies; Cost benefit analysis; Discrimination; Economic; Economics and Finance; Epidemics; Full-income; Health care expenditures; HIV; Human immunodeficiency virus; Humanities and Social Sciences; Investments; Life Sciences; Mortality; Prevention; Productivity; Public health; Return on investment; Services; Valuation; Value; Values
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2018.11.007

•Ending AIDS as a public health threat is a highly efficient investment.•Each dollar invested using the Fast-Track strategy brings US$6.44 of economic benefits.•Economic returns under the full-income and productivity approaches are consistent.•The full-income approach for health captures social benefits beyond gains in productivity. In 2016, countries agreed on a Fast-Track strategy to “end the AIDS epidemic by 2030”. The treatment and prevention components of the Fast-Track strategy aim to markedly reduce new HIV infections, AIDS-related deaths and HIV-related discrimination. This study assesses the economic returns of this ambitious strategy. We estimated the incremental costs, benefits and economic returns of the Fast-Track scenario in low- and middle-income countries, compared to a counterfactual defined as maintaining coverage of HIV-related services at 2015 levels. The benefits are calculated using the full-income approach, which values both the changes in income and in mortality, and the productivity approach. The incremental costs of the Fast-Track scenario over the constant scenario for 2017–2030 represent US$86 billion or US$13.69 per capita. The full-income valuation of the incremental benefits of the decrease in mortality amounts to US$88.14 per capita, representing 6.44 times the resources invested for all countries. These returns on investment vary by region, with the largest return in the Asia-Pacific region, followed by Eastern and Southern Africa. Returns using the productivity approach are smaller but ranked similarly across regions. In all regions, the economic and social value of the additional life-years saved by the Fast-Track approach exceeds its incremental costs, implying that this strategy for ending the AIDS epidemic is a sound economic investment.