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Efficiency the key for global HIV/​AIDS programs

Richard Wamai, an assis­tant pro­fessor of public health in the Depart­ment of African Amer­ican Studies and an expert in HIV/AIDS research and policy, said advance­ments in pre­ven­tion and treat­ment of the dis­ease have yielded two pos­i­tive trends: HIV/​AIDS patients are living longer, and the number of new cases is steadily declining.

But Wamai also struck a note of cau­tion, adding that the world­wide eco­nomic crisis has threat­ened funding for HIV/ ​AIDS pre­ven­tion and treat­ment. As a result, he said, gov­ern­ments and agen­cies must opti­mize the resources at their disposal.

To this end, Wamai is part of a global con­sor­tium of researchers that is leading a study to iden­tify the most effi­cient way of allo­cating funds for HIV/​AIDS inter­ven­tions among affected pop­u­la­tions. The project, sup­ported by the Bill & Melinda Gates Foun­da­tion, is focused in five coun­tries: Kenya, Zambia, Rwanda, South Africa, and Nigeria—all of which are located in Sub-​​Saharan Africa, where 22.5 mil­lion people live with HIV/​AIDS, com­prising 68 per­cent of the world’s total.

“There is a crit­ical need for coun­tries to use the funding avail­able in a more effi­cient way,” said Wamai, noting that the number of people who become infected out­strip those who receive treat­ment. “Can they pro­vide HIV/​AIDS ser­vices at an increas­ingly lower cost without com­pro­mising quality? That’s a ques­tion we’re com­mitted to answering.”

In recog­ni­tion for his work in this field, Wamai was recently hon­ored with the 2012 World AIDS Day Unsung Hero Award by Blood:Water Mis­sion. The Nashville, Tenn.-based non­profit empowers com­mu­ni­ties to work together against the HIV/​AIDS and water crises in Africa.

Wamai is also co-​​founder of Northeastern’s Global Health Ini­tia­tive along with Michael Pol­lastri, asso­ciate pro­fessor of chem­istry and chem­ical biology.

In December, Wamai spent two weeks in Kenya, over­seeing the research team’s efforts to gather hordes of data from com­pre­hen­sive sur­veys of health facil­i­ties and indi­vid­uals infected with HIV/​AIDS. The study is being con­ducted at 135 sites throughout the country.

The project—Optimizing the Response of HIV/​AIDS Pre­ven­tion in Africa (ORPHEA)—is focused on deter­mining the actual costs of pro­viding a unit of ser­vice for HIV/​AIDS inter­ven­tions, and how that process can become even more cost effective.

In par­tic­ular, the project will mea­sure the tech­nical effi­ciency of four HIV/​AIDS pre­ven­tion inter­ven­tions: mother-​​to-​​child trans­mis­sion, male cir­cum­ci­sion, HIV testing and coun­seling, and male and female sex workers’ access to treat­ment and services.

Wamai noted that he expects all the data to be col­lected in the focus coun­tries by the summer of 2013. The con­sor­tium of researchers will ulti­mately pro­vide rec­om­men­da­tions on improving effi­ciency in the pro­duc­tion and delivery of HIV pre­ven­tion ser­vices. Their rec­om­men­da­tions can be used to inform pol­i­cy­makers and foster con­tinued research.

“This is the largest HIV/​AIDS cost-​​effectiveness study done to date,” Wamai said.

View selected pub­li­ca­tions of Richard Wamai in IRis, Northeastern’s dig­ital archive.

– by Greg St. Martin

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