Assessment of Allocative Efficiency Tools to Support Country HIV Program Planning and Budget Allocation

The HIV epidemic continues to be a major global health challenges, with more than 33 million people infected worldwide. Despite the fact that financial resources for HIV programs tended to increase between 2000 and 2010, the current scenario has changed and resources have not been increasing at the same rapid rate in more recent years. Moreover, the financial requirements of HIV programs have substantially increased as more people are eligible to access antiretroviral therapy (ART) and as the need to maintain a core set of effective, and non-ART based HIV prevention services remain critical. As a consequence, funds for HIV prevention and treatment still fall far short of the estimated needs. Under this framework, the allocative efficiency (AE) concept has become a key approach to maximize the health outcome derived from what each country can invest for health care. AE analysis emerges as a fundamental concept to answer a current key question: How should the available resources be allocated in order to maximize their returns in terms of public health outcomes?

In this context, mathematical modeling has become a powerful tool to support AE analyses. It is an essential step to assist in the selection process of program interventions that can achieve maximum health impact within a given budget. Today, a wide range of programmatic and AE research tools that use mathematical modeling as the basic analytical tool are available making this a timely opportunity to understand and discuss the different approaches used by the many different available tools.

The HIV Modelling Consortium convened a workshop with the research groups that developed allocative efficiency tools Goals, AIDS Epidemic Model (AEM), and OPTIMA in Vancouver, Canada on Saturday 18 July 2015. The aim of the workshop was to provide an opportunity for developers of AE tools (AEM, Goals, Optima), to discuss and review the technical characteristics of their models, as well as the different approaches taken by models to address specific HIV policy questions. The discussion focused specifically on the technical description of the epidemiological and financial frameworks of each model used, including data requirements, country examples, and limitations of the model. 

A meeting report is currently in development and will be made available on the HIV Modelling Consortium website in due course.