QUESTION FOUR 1. Under what circumstances do you use the following techniques: a. Cost Effective Analysis [2 marks] b. Cost Utility Analysis[2 marks] Suppose you are trying to decide how to spend some funds on preventing HIV transmission. Two interventions you are considering are screening blood transfusions for HIV and improving syndromic management of sexually-transmitted diseases (STDs). Both interventions have been shown to reduce HIV transmission: the former by reducing the risk of transmission through blood transfusion and the latter by reducing the transmission through lesions caused by (non-HIV) STDs. You have the results of two studies -one was carried out in Monze, Zambia (Foster and Buv 1995) and the other in Mwanza, Tanzania (Gilson et al. 1997). Suppose the measure of outcome chosen is HIV infections prevented (see Table 1.1 below). Monze district hospital is one of approximately 50 district hospitals in Zambia. Table 1.1: Two interventions to prevent HIV transmission Intervention Incremental intervention cost (S) HIV infections prevented 150 Cost/HIV infection prevented (S) 31.63 4 745 Monze, Zambia: blood transfusion screening Mwanza, Tanzania: STD treatment 54 839 252 217.62 Sources: Foster and Buv (1995); Gilson et al. (1997) Suppose you have just received word that a donor has promised $1 million a year for the next five years for HIV prevention. You want to allocate it between blood transfusion screening at district hospitals and improved STD treatment at clinics. Answer the following questions, using the figures given in Table 1.1. a. Assuming the cost of screening would be the same for all 50 district hospitals, what would be the cost of HIV screening of transfusions for all the district hospitals of the country? [3 marks] b. If you had $1 million to spend on HIV prevention, given these figures, how would you allocate the resources between these two interventions? [4 marks] c. How many infections would each prevent, and what would be the total number of infections you could prevent using this $1 million? [4 marks] QUESTION FOUR 1. Under what circumstances do you use the following techniques: a. Cost Effective Analysis [2 marks] b. Cost Utility Analysis[2 marks] Suppose you are trying to decide how to spend some funds on preventing HIV transmission. Two interventions you are considering are screening blood transfusions for HIV and improving syndromic management of sexually-transmitted diseases (STDs). Both interventions have been shown to reduce HIV transmission: the former by reducing the risk of transmission through blood transfusion and the latter by reducing the transmission through lesions caused by (non-HIV) STDs. You have the results of two studies -one was carried out in Monze, Zambia (Foster and Buv 1995) and the other in Mwanza, Tanzania (Gilson et al. 1997). Suppose the measure of outcome chosen is HIV infections prevented (see Table 1.1 below). Monze district hospital is one of approximately 50 district hospitals in Zambia. Table 1.1: Two interventions to prevent HIV transmission Intervention Incremental intervention cost (S) HIV infections prevented 150 Cost/HIV infection prevented (S) 31.63 4 745 Monze, Zambia: blood transfusion screening Mwanza, Tanzania: STD treatment 54 839 252 217.62 Sources: Foster and Buv (1995); Gilson et al. (1997) Suppose you have just received word that a donor has promised $1 million a year for the next five years for HIV prevention. You want to allocate it between blood transfusion screening at district hospitals and improved STD treatment at clinics. Answer the following questions, using the figures given in Table 1.1. a. Assuming the cost of screening would be the same for all 50 district hospitals, what would be the cost of HIV screening of transfusions for all the district hospitals of the country? [3 marks] b. If you had $1 million to spend on HIV prevention, given these figures, how would you allocate the resources between these two interventions? [4 marks] c. How many infections would each prevent, and what would be the total number of infections you could prevent using this $1 million? [4 marks]
