Recurrent costs of HIV/AIDS-related health services in Rwanda: implications for financing

• Published in: Tropical medicine & international health Vol. 13; no. 10; pp. 1245 - 1256
• Main Authors: Quentin, Wilm, König, Hans-Helmut, Schmidt, Jean-Olivier, Kalk, Andreas
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.10.2008; Blackwell Publishing Ltd
• Subjects: Africa; Afrique; AIDS Serodiagnosis - economics; Anti-Retroviral Agents - economics; Anti-Retroviral Agents - therapeutic use; antiretroviral therapy; Antiretroviral Therapy, Highly Active - economics; Cost-Benefit Analysis - economics; costes y análisis de costes; costs and cost analysis; coûts et analyse des coûts; Developing Countries - economics; economics; economía; Female; Health Care Costs; Health care expenditures; Health Services Needs and Demand - economics; HIV; HIV infections; HIV Infections - drug therapy; HIV Infections - economics; HIV-1; Human immunodeficiency virus; Humans; infecciones oportunistas; infections opportunistes; Male; Medical treatment; opportunistic infections; Rwanda; Terapia anterretroviral; thérapie antirétrovirale; VIH; África; économie; Africa; Rwanda
• DOI: 10.1111/j.1365-3156.2008.02142.x
• ISSN: 1360-2276; 0365-6527

To estimate recurrent costs per patient and costs for a national HIV/AIDS treatment programme model in Rwanda. A national HIV/AIDS treatment programme model was developed. Unit costs were estimated so as to reflect necessary service consumption of people living with HIV/AIDS (PLWHA). Two scenarios were calculated: (1) for patients/clients in the year 2006 and (2) for potential increases of patients/clients. A sensitivity analysis was conducted to test the robustness of results. Average yearly treatment costs were estimated to amount to 504 US$ per patient on antiretroviral therapy (ART) and to 91 US$ for non-ART patients. Costs for the Rwandan HIV/AIDS treatment programme were estimated to lie between 20.9 and 27.1 million US$ depending on the scenario. ART required 9.6 to 11.1 million US$ or 41-46% of national programme costs. Treatment for opportunistic infections and other pathologies consumed 7.1 to 9.3 million US$ or 34% of total costs. Health Care in general and ART more specifically is unaffordable for the vast majority of Rwandan PLWHA. Adequate resources need to be provided not only for ART but also to assure treatment of opportunistic infections and other pathologies. While risk-pooling may play a limited role in the national response to HIV/AIDS, considering the general level of poverty of the Rwandan population, no appreciable alternative to continued donor funding exists for the foreseeable future.