July 2004 HIVAN/ECI Public Health Journal Club

Brief Overview: ?“A review of ARV costing models in South Africa?” and ?“Cost-Effectiveness of HIV interventions in Africa: a systematic review?” were the topics of the July 2nd Journal Club at the Nelson R Mandela School of Medicine. Karen Michael and Nicola Deghaye, respectively, presented on these subjects.

The aim of Karen?’s paper was to compare the questions, methodologies and conclusions of four different antiretroviral costing models in South Africa. Boulle et al stress the importance of the political context in which the modelling was done although this is not an explicit theme of the review. The presentation made conclusions about the limitations of modelling, and the uses of cost-effective analyses were sketched out in the discussion.

Nicola Deghaye presented a systematic review of a broad range of HIV/AIDS interventions in Africa, by Creese, Floyd, Alban & Guiness. The presentation included a discussion of the methodology of the study, potential problems encountered and a brief review of the results. There was some discussion of how cost-effectiveness of ARVs may have changed following the decreases in drug prices. The presentation included a discussion about the generalisability of findings in a particular African country to the whole of the continent.

References for July Journal Club:

Boulle, A., Kenyon, C. and Abdullah, F. (2003). A review of Antiretroviral Costing Models in South Africa in Moatti J.P., Coriat, B., Souteyrand, Y., Barnett, T., Dumoulin and J., Flori, Y.A. (Eds.) Economics of AIDS and access to HIV/AIDS care in developing countries. Issues and challenges. Paris: Agence Nationale de Recherches sur le Sida.

Creese, A., Floyd, K., Alban, A. and Guiness, L. (2002). ?“Cost-effectiveness of HIV/AIDS interventions in Africa: a systematic review of the evidence.?” Lancet 359 (May)

Biosketches:

Karen Michael - Karen Michael has a Masters in Development Studies from the University of KwaZulu-Natal. She majored in Philosophy and studied Health Economics at the University of Wales through a DFID Technical Cooperation Award. She is about to register for her second Masters degree pursuing her interests in Health Economics. She is the resident Health Economist and programme manager at Enhancing Care Initiative KZN PLUS and is co-facilitating the Health Economics Interest Group with Nicola Deghaye. Apart from her rather obvious interests in Economics, Karen is an avid rock-climber and has a rather morbid fascination with plagues and epidemics.

Nicola Deghaye - Nicola Deghaye works as a Health Economics Researcher at Enhancing Care Initiative KZN PLUS at the Nelson R. Mandela School of Medicine. Nicola?’s background is in Economics. She completed her BCom and BCom Honours in Economics at the University of KwaZulu-Natal. She has worked in market research and as an industry analyst in the banking sector. She completed an MSC in Health Economics at the University of York, England in 2003. Her research interests include the economic evaluation of HIV/AIDS treatment strategies.