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Optimizing Investments in the National HIV Response of Mexico

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Date
2018-03
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2018-03
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Gutierrez, Catalina
Macias, Claudia
Petravic, Janka
Lavadenz, Luis
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Abstract
Despite a substantial improvement in controlling new infections of HIV over the last ten years, Mexico is experiencing a low-level epidemic with approximately 180,000 people living with HIV (Spectrum, 2013), making it the fourth ranking country in Latin America with regards to the number of people with the disease (PLHIV). The objective of increasing coverage and reducing inequality in the country is reflected in the objectives of the Specific Action Program (PAE) for the national response to HIV, AIDS and STI of 2013-2018 (Secretaria de salud), which seeks to decrease the effect of HIV and STIs, implement prevention strategies and provide comprehensive care for vulnerable population groups and those living in poverty. The possibility of achieving the objectives of the PAE is closely related to the total amount of resources that Mexico can commit to fighting HIV and the way these resources are allocated. In the hopes of assisting the Government of Mexico in further strengthening its HIV investment, the authors try to answer the question How can HIV funding be optimally allocated to the combination of HIV response interventions that will yield the highest impact in the shortest period. The study found that despite the overall greater costs of treatment with ART, this is the most cost-effective program. ART not only reduces deaths but is an effective measure to prevent new infections due to the reduction of viral load to undetectable levels. As such, the most cost-effective allocation – with no additional resources of current Program funds, is to scale up treatment, by about 4 to 8 percent, to maximize ART coverage while slightly reducing overall allocations to general population prevention.This slight increase would avert 4,235 deaths and 3,371 new infections, and improve health outcomes by around 6 percent. To increase the value-for-money of existing resources, allocation efficiency would also require the strengthening of CENSIDA´s stewardship role, to ensure that the funds transferred are invested as they were initially earmarked.
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Gutierrez, Catalina; Lavadenz, Fernando; Macias, Claudia; Petravic, Janka; Lavadenz, Luis. 2018. Optimizing Investments in the National HIV Response of Mexico. Health, Nutrition and Population Discussion Paper;. © World Bank. http://hdl.handle.net/10986/29821 License: CC BY 3.0 IGO.
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