XIX International AIDS Conference


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MOAE0306 - Oral Abstract

Funding universal access to antiretroviral treatment through a 'Global Health Charge' on alcohol and tobacco consumption: feasibility in the 20 countries with the largest HIV epidemics

Presented by Andrew Hill (United Kingdom).

A. Hill1, W. Sawyer2

1Liverpool University, Pharmacology and Therapeutics, London, United Kingdom, 2MetaVirology Ltd, Statistics, London, United Kingdom

Background: Current funding levels from PEPFAR / Global Fund may be too low to ensure Universal Access to antiretrovirals (ARVs) in the long-term. Additional, sustainable sources of funding are required.
Methods: For the 20 countries with the largest HIV epidemics, the additional costs required to achieve Universal Access were calculated, using WHO 2011 estimates of patient numbers requiring ARV treatment, combined with Clinton Foundation prices of ARVs, and PEPFAR estimates of cost of care/diagnostics. WHO estimates of adult population size, annual alcohol and tobacco consumption (commercially supplied) were used to estimate annual revenues from a “Global Health Charge” of 1 US cent per 10mL unit of alcohol, and 10c per 20 cigarettes.
Results: In the 20 countries with largest HIV epidemics, 5.2/11.3 million eligible patients were receiving antiretrovirals (coverage 46%). The minimum cost of care was $861 per patient-year (antiretrovirals, $406, medical $300, diagnostics $155). Ten of the 20 countries (Botswana, Brazil, China, India, Nigeria, Thailand, Russia, Uganda, Ukraine and Vietnam), could fund 100% of Universal Access costs from National revenue using the “Global Health Charge”: $2.57 of the total $17.97 billion of revenue collected per year would cover treatment of 3.0 million eligible patients in these countries. In the other 10 countries (Cameroun, Cote d'Ivoire, DR Congo, Kenya, Malawi, Mozambique, Tanzania, South Africa, Zambia, Zimbabwe) $937 million could be collected annually with the Global Health Charge: sufficient to treat 1.1 million eligible patients (35% of the additional $2.67 billion budget required for Universal Access).
Conclusions: A “Global Health Charge” of 1 US cent per unit of alcohol, and 10 cents per 20 cigarettes, collected and spent at a National level, would be sufficient to fund an additional 4.1 million patients per year with antiretroviral treatment and care; Universal Access could be acheived in 10 of the 20 countries with this system.

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