The unit cost per person for the scaled-up campaign was estimated to be $6.27 for malaria (nets, education, and training), $15.80 ($2.55 per person-year) for diarrhea (filters, education, and training), and $9.92 for HIV (test kits, counseling, condoms, education, and CD4 testing).
Panel 1: IPC Cost, health impact, and cost-effectiveness
James G. Kahn, MD, MPH UCSF25 July 2012
Goal of analysis Estimate the cost, health effects, and cost-effectiveness of a diarrhea, malaria and HIV IPC as implemented in Lurambi district, Western Kenya, September 2008.
Methods: SourcesProgram costs: Empirical for campaign as implemented, plus modeled “Scaled-Up Replication” (SUR)Health effects (deaths and DALYs averted): Published trials and meta-analyses, and disease incidence modelingCosts of medical care incurred/averted: Published studies and databases
Results: Program Costs As implemented: $42 SUR: $32 Diarrhea: $15.80 Malaria: $6.27 HIV: $9.92
Results: Health Effects Deaths and DALYs averted by intervention component: HIV Diarrhea Malaria (VCT, (Filters) (LLIN) condoms) TOTALDeaths averted 6.81 4.31 5.22 16.3DALYs averted 191 125 42 358.5(prevention)DALYsaverted(earlier -- -- 82 82HIV care)TOTAL DALYs 191 125 125 441.8
Results: Costs Costs averted/(added) by intervention component: Diarrhea Malaria HIV (VCT, (Filters) (LLIN) condoms) TOTALPrevention $48,123 $10,420 $25,569 $85,113Effect on use -- -- ($37,097) ($37,097)of ARTTotal $48,123 $10,420 ($10,538) $48,015
Results: Cost-effectiveness Unadjusted campaign cost: $32,000 Net cost (savings): ($16,015) Cost per DALY averted: Net savings
Conclusion A mass, rapidly implemented IPC for HIV, malaria and diarrhea in a Western Kenya setting provides substantial health benefits in terms of deaths and DALYs averted The campaign also appears economically attractive (cost-saving).