||joya banerjee [ profile ]
CGHP Publication: Medical male circumcision as HIV prevention: followthe evidence: the case for aggressive scale-up
Mar 10th, 2011 - 06:58:36
Some of you may have seen this excellent resource on MMC. It provides
a brief synthesis of MMC's protective benefits, responses to the
questions that regularly come up around MMC and HIV prevention, and a
great costing of MMC compared to AIDS treatment.
Mathematical modeling shows that universal medical MC
across 14 target areas in Africa, estimated at 29.1 million
circumcisions, could prevent up to six million new HIV
infections and three million deaths in the next two
In high prevalence settings, medical MC is cost effective and
even cost saving. Models predict that, using a 10-year time
horizon, one new HIV infection can be averted for every
five to 15 men newly circumcised.58 Using this model, the
cost to avert one HIV infection ranges from $150 to $900.57
According to UNITAID, treating a patient for one year with
todays recommended first-line AIDS treatment costs
between $151 and $1,033.69 That does not include any
other health-related costs such as treatment of opportunistic
infections, or opportunity costs associated with an
HIV-infected person missing work or being unable to care
for children due to illness.
As the impact of MC grows over time, the number of MCs
needed per infection averted declines. USAID estimates
that between 2016 and 2025, 3.7 MCs will be required to
avert one HIV infection in Lesotho, while only 1.6 MCs will
be needed to avert one HIV infection in Nyanza, Kenya.
With that in mind, the greatest cost-effectiveness can be
achieved with a two-pronged implementation approach
that combines accelerated medical MC saturation for adults
and adolescents and sustained programs for neonates.
WE HAVE TO ACT FAST
The more quickly we implement this proven prevention
intervention, the greater the impact will be on the
individual, community and country levels.
Economic models show that scaling up MC to reach 80
percent of all adult and newborn males by 2015 would
reduce the number of new adult HIV infections by about 40
percent by the end of 2025. The impact is directly
proportional to the implementation pace and scale.
What is more, spending $1 billion to achieve this impact
will also save $20.3 billion in the long run.