Publication: The Potential Demand for and Strategic Use of an HIV-1 Vaccine in Southern India
Loading...
Published
2003-05
ISSN
Date
2014-05-09
Editor(s)
Abstract
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.
Link to Data Set
Citation
“Seshadri, Shreelata Rao; Subramaniyam, P.; Jha, Prabhat. 2003. The Potential Demand for and Strategic Use of an HIV-1 Vaccine in Southern India. Policy Research Working Paper;No. 3066. © http://hdl.handle.net/10986/18219 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Publication Global Poverty Revisited Using 2021 PPPs and New Data on Consumption(Washington, DC: World Bank, 2025-06-05)Recent improvements in survey methodologies have increased measured consumption in many low- and lower-middle-income countries that now collect a more comprehensive measure of household consumption. Faced with such methodological changes, countries have frequently revised upward their national poverty lines to make them appropriate for the new measures of consumption. This in turn affects the World Bank’s global poverty lines when they are periodically revised. The international poverty line, which is based on the typical poverty line in low-income countries, increases by around 40 percent to $3.00 when the more recent national poverty lines as well as the 2021 purchasing power parities are incorporated. The net impact of the changes in international prices, the poverty line, and new survey data (including new data for India) is an increase in global extreme poverty by some 125 million people in 2022, and a significant shift of poverty away from South Asia and toward Sub-Saharan Africa. The changes at higher poverty lines, which are more relevant to middle-income countries, are mixed.Publication The Macroeconomic Implications of Climate Change Impacts and Adaptation Options(Washington, DC: World Bank, 2025-05-29)Estimating the macroeconomic implications of climate change impacts and adaptation options is a topic of intense research. This paper presents a framework in the World Bank's macrostructural model to assess climate-related damages. This approach has been used in many Country Climate and Development Reports, a World Bank diagnostic that identifies priorities to ensure continued development in spite of climate change and climate policy objectives. The methodology captures a set of impact channels through which climate change affects the economy by (1) connecting a set of biophysical models to the macroeconomic model and (2) exploring a set of development and climate scenarios. The paper summarizes the results for five countries, highlighting the sources and magnitudes of their vulnerability --- with estimated gross domestic product losses in 2050 exceeding 10 percent of gross domestic product in some countries and scenarios, although only a small set of impact channels is included. The paper also presents estimates of the macroeconomic gains from sector-level adaptation interventions, considering their upfront costs and avoided climate impacts and finding significant net gross domestic product gains from adaptation opportunities identified in the Country Climate and Development Reports. Finally, the paper discusses the limits of current modeling approaches, and their complementarity with empirical approaches based on historical data series. The integrated modeling approach proposed in this paper can inform policymakers as they make proactive decisions on climate change adaptation and resilience.Publication Gender Gaps in the Performance of Small Firms: Evidence from Urban Peru(Washington, DC: World Bank, 2025-09-23)This paper estimates the gender gap in the performance of firms in Peru using representative data on both formal and informal firms. On average, informal female-led firms have lower sales, labor productivity, and profits compared to their male-led counterparts, with differences more pronounced when controlling for observable determinants of firm performance. However, gender gaps are only significant at the bottom of the performance distribution of informal firms, and these gaps disappear at the top of the distribution of informal firms and for formal firms. Possible explanations for the performance gaps at the bottom of the distribution include the higher likelihood of small, female-led firms being home-based, which is linked to lower profits, and their concentration in less profitable sectors. The paper provides suggestive evidence that household responsibilities play a key role in explaining the gender gap in firm performance among informal firms. Therefore, policies that promote access to care services or foster a more equal distribution of household activities may reduce gender productivity gaps and allow for a more efficient allocation of resources.Publication The Exposure of Workers to Artificial Intelligence in Low- and Middle-Income Countries(Washington, DC: World Bank, 2025-02-05)Research on the labor market implications of artificial intelligence has focused principally on high-income countries. This paper analyzes this issue using microdata from a large set of low- and middle-income countries, applying a measure of potential artificial intelligence occupational exposure to a harmonized set of labor force surveys for 25 countries, covering a population of 3.5 billion people. The approach advances work by using harmonized microdata at the level of individual workers, which allows for a multivariate analysis of factors associated with exposure. Additionally, unlike earlier papers, the paper uses highly detailed (4 digit) occupation codes, which provide a more reliable mapping of artificial intelligence exposure to occupation. Results within countries, show that artificial intelligence exposure is higher for women, urban workers, and those with higher education. Exposure decreases by country income level, with high exposure for just 12 percent of workers in low-income countries and 15 percent of workers in lower-middle-income countries. Furthermore, lack of access to electricity limits effective exposure in low-income countries. These results suggest that for developing countries, and in particular low-income countries, the labor market impacts of artificial intelligence will be more limited than in high-income countries. While greater exposure to artificial intelligence indicates larger potential for future changes in certain occupations, it does not equate to job loss, as it could result in augmentation of worker productivity, automation of some tasks, or both.Publication Geopolitical Risks and Trade(Washington, DC: World Bank, 2025-09-23)This paper studies the impact of geopolitical risks on international trade, using the Geopolitical Risk (GPR) index of Caldara and Iacoviello (2022) and an empirical gravity model. The impact of spikes in geopolitical risk on trade is negative, strong, and heterogeneous across sectors. The findings show that increases in geopolitical risk reduce trade by about 30 to 40 percent. These effects are equivalent to an increase of global tariffs of up to 14 percent. Services trade is most vulnerable to geopolitical risks, followed by agriculture, and the impact on manufacturing trade is moderate. These negative effects are partially mitigated by cultural and geographic proximity, as well as by the presence of trade agreements.
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Public Health Surveillance Toolkit : A Guide for Busy Task Managers(World Bank, Washington, DC, 2002-02)This toolkit draws on the expertise of public health practitioners who have experience with public health surveillance and who have recognized the core role of surveillance in public health. These practitioners have advocated for surveillance programs, supplied innovative ideas, and provided insightful critiques over many years. This toolkit also draws on the experience of Bank staff and technical experts from the PAHO and the CDC who have contributed to Bank missions. The toolkit also makes use of WHO references, primarily those from the WHO s Web site. Part A of this toolkit provides some theoretical concepts, and knowledge about surveillance that has been gained through applying these concepts and the practice of surveillance in developing countries. Part B provides information that will be useful to Task Managers as they prepare loans for strengthening public health surveillance systems. Several World Bank experiences are shared. The focus of part B is on practical aspects of surveillance and on lessons learned.Publication HIV/AIDS(Washington, DC, 2003-10)The epidemic spread of HIV/AIDS has been ferocious, posing a great threat, not only to public health, but to social sectors, and to development itself, while the fiscal cost of HIV/AIDS is significant as well. A set of effective prevention interventions include: changing behavior through communication; making the use of condoms, diagnosis, and treatment of sexually transmitted diseases, including counseling and testing, available and affordable; ensuring a safe blood supply; and, preventing parent-to-child transmission. In addition, countries should consider implementing programs to provide cost-effective management of common opportunistic infections. Similarly, community-based, and home-based care should be made available, in addition to traditional hospital care, particularly in countries with a generalized epidemic. Lessons convey the vital need for early action, supported by community participation, targeting the most vulnerable, and prioritizing interventions, while governments should be committed to its prevention, control, and funding. Additionally, nongovernmental organizations' participation plays a decisive role against the epidemic spread, in their capacity for social mobilization, and in reaching marginal groups.Publication Lesotho : The Development Impact of HIV/AIDS Selected Issues and Options(Washington, DC, 2000-10-18)This report aims to provide an overview of selected likely development impact of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) for Lesotho. The purpose is to engage in a dialogue with the Government, relevant stakeholders and the donor community on the appropriate actions to pursue in support of the Government's recently developed strategy on the epidemic. This report is to assist policy makers in Lesotho in their effort to incorporate HIV/AIDS into the planning process on a regular basis. As such, it is directed at officials at the ministries of finance and development planning. It employs conventional demographic and economic models to analyze selected development impacts of HIV/AIDS on the economy, thereby providing an illustration of how these impacts can be incorporated in the regular planning processes (including annual budgeting) in the finance and development ministries of the Government. It points out the need for monitoring the progression of the epidemic through further research and improvements in existing instruments. The report identifies three areas where the HIV/AIDS impact is severe and need further appropriate studies: a) household; b) public sector; and c) integration of HIV/AIDS into planning models and decision making.Publication Botswana : Selected Development Impact of HIV/AIDS(Washington, DC, 2001-04-20)The objective of this report is to provide an overview of the selected likely development impact of HIV/AIDS for Botswana. The purpose is to develop a framework for dialogue with the Government, relevant stakeholders, and the donor community on the appropriate actions to pursue in support of the Government's strategy on the epidemic. The review was also initiated as an exercise to complement the efforts of policymakers in Botswana to incorporate HIV/AIDS into the planning process on a regular basis. As such, it is directed at the officials at the ministries of finance and development planning. It employs conventional demographic and economic models to analyze selected development impacts of HIV/AIDS on the economy, thereby providing an illustration of how these impacts can be incorporated in the regular planning processes (including annual budgeting) in the finance and development ministries of the Government. It points out the need for monitoring the progression of the epidemic through further research and improvements in the existing research instruments.Publication The Global HIV Epidemics among People Who Inject Drugs(Washington, DC: World Bank, 2013-01)This publication addresses research questions related to an increase in the levels of access and utilization for four key interventions that have the potential to significantly reduce HIV infections among People Who Inject Drugs (PWID) and their sexual and injecting partners, and hence morbidity and mortality in low and middle-income countries (LMIC). These interventions are drawn from nine consensus interventions that comprise a 'comprehensive package' for PWID. The four interventions are: Needle and Syringe Programs (NSP), Medically Assisted Therapy (MAT), HIV Counseling and Testing (HCT), and Antiretroviral Therapy (ART). The book summarizes the results from several recent reviews of studies related to the effectiveness of the four key interventions in reducing risky behaviors in the context of transmitting or acquiring HIV infection. Overall, the four key interventions have strong effects on the risk of HIV infection among PWID via different pathways, and this determination is included in the documents proposing the comprehensive package of interventions. In order to attain the greatest effect from these interventions, structural issues must be addressed, especially the removal of punitive policies targeting PWID in many countries. The scientific evidence presented here, the public health rationale, and the human rights imperatives are all in accord: we can and must do better for PWID. The available tools are evidence-based, right affirming, and cost effective. What are required now are political will and a global consensus that this critical component of global HIV can no longer be ignored and under-resourced.
Users also downloaded
Showing related downloaded files
Publication Lebanon Economic Monitor, Fall 2022(Washington, DC, 2022-11)The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Morocco Economic Update, Winter 2025(Washington, DC: World Bank, 2025-04-03)Despite the drought causing a modest deceleration of overall GDP growth to 3.2 percent, the Moroccan economy has exhibited some encouraging trends in 2024. Non-agricultural growth has accelerated to an estimated 3.8 percent, driven by a revitalized industrial sector and a rebound in gross capital formation. Inflation has dropped below 1 percent, allowing Bank al-Maghrib to begin easing its monetary policy. While rural labor markets remain depressed, the economy has added close to 162,000 jobs in urban areas. Morocco’s external position remains strong overall, with a moderate current account deficit largely financed by growing foreign direct investment inflows, underpinned by solid investor confidence indicators. Despite significant spending pressures, the debt-to-GDP ratio is slowly declining.Publication Argentina Country Climate and Development Report(World Bank, Washington, DC, 2022-11)The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.Publication World Development Report 2006(Washington, DC, 2005)This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.