The Epidemiological Impact Of An Hiv Vaccine On The Hiv Aids Epidemic In Southern India

Even a modestly effective HIV-1 vaccine would be highly useful in India and could avoid millions of deaths. How should such a vaccine be introduced? Based on evidence of adoption of other vaccines in India, current levels of spending on them and coverage of prevention programs targeting both high- and low-risk groups, Seshadri, Subramaniyam, and Jha assess the potential demand for and strategic use of an HIV-1 vaccine in the four southern Indian states of Andhra Pradesh, Karnataka, Maharashtra, and Tamil Nadu. The authors also discuss potential strategies for delivery of the vaccine, prioritization for vaccination, and the political economy of such a vaccine in India. Assuming a vaccine cost of $10 a dose and including estimated delivery costs, the total cost of vaccinating 21.6 million adolescents 11-14 years of age and 1 percent of adults would be Rs. 12.25 billion (US$ 245 million). To maintain the vaccination rate in the 11-14 year old cohort, an additional 6.77 million in that age range would have to be vaccinated each year, at a vaccine cost of Rs. 3.39 billion (US$ 67.5 million). An HIV-1 vaccine will greatly reduce HIV/AIDS in India, but it will not be a panacea. There will be a continued need for effective prevention programs to guard against behavior reversals or an imperfect vaccine. Key inputs for prevention, immunization, and treatment programs such as identification of various groups that could be immunized (vulnerable groups or general populations), strengthened surveillance, capacity building, operations research, and evaluation at local levels will continue to require intensive support. This paper--a product of Public Services, Development Research Group--is part of the research project on The Economics of an HIV/AIDS Vaccine in Developing Countries: Potential Impact, Cost-Effectiveness, and Willingness to Pay," sponsored by the European Commission and the Development Research Group of the World Bank. The project was launched in response to recommendations of the World Bank's AIDS Vaccine Task Force.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

This comprehensive reference book addresses the unique challenges facing many African nations as poor infrastructure and economics continue to obstruct access to advanced treatments and AIDS care training. It takes into account the context of settings with limited resources. Information on how to best utilize existing resources and prioritize scaling-up of infrastructure is a critical aspect of this book for those working in HIV/AIDS-related fields in Africa.

This title projects the future implications of three alternative AIDS treatment financing policies for the health burden of AIDS in India and for its overall health expenditures. Written by an interdisciplinary team of AIDS experts, the book presents new data on the supply and demand for antiretroviral treatment in India and new models of the epidemiological effects and the financial costs of alternative policies.