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Background-Ethiopia

Scenario –based Cost Projections for PEPFAR Resource Requirements for the ART Program in Ethiopia from FY2011 – FY2015 Solomon Ahmed, M.D. Technical Officer-Treatment Centers for Disease Control and Prevention-Ethiopia. Background-Ethiopia. Total Population – 80 million+

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Background-Ethiopia

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  1. Scenario –based Cost Projections for PEPFAR Resource Requirements for the ART Program in Ethiopia from FY2011 – FY2015Solomon Ahmed, M.D. • Technical Officer-Treatment • Centers for Disease Control and Prevention-Ethiopia

  2. Background-Ethiopia • Total Population – 80 million+ • HIV prevalence* – 2.4% • ART eligible – 397,818 (26,053 < 15 years) • Currently on ART March 2012** – 257,000+ * 1.5% from the 2011 DHS results. ** PEPFAR Ethiopia SAPR http://www.smartraveller.gov.au/zwiki/pub/Maps/countries/dfat/Ethiopia.jpg http://mapsof.net/uploads/static-maps/where_is_ethiopia_located.png

  3. Background - Ethiopia Trends in no. of PLHIV enrolled to care and ART in Ethiopia from 2005 - 2011 700,000 600,000 500,000 400,000 300,000 200,000 100,000 Number of PLHIV Year HSDP IV Annual Performance Report EFY 2003 (2010/11)

  4. Activities supported for site level services

  5. Objective of study • Provide PEPFAR-Ethiopia with funding projections for different scenarios of scale-up

  6. Methods • Utilized results from FY 2010 expenditure analysis to calculate unit costs • Used the PEPFAR ART Costing model 2010 • Developed different scenarios based on rates of enrollment of new patients

  7. PEPFAR expenditures included • Service delivery support • Procurement cost of ARVs (contingency), lab reagents, and other commodities • Technical support and managerial overheads provided by PEPFAR-funded implementing partners

  8. PEPFAR expenditures excluded • Managerial overheads incurred within USG government agencies • Costs of related services from other program areas (HIV testing, PMTCT, community-based care)

  9. Scale-up Scenarios used for cost projections

  10. Assumptions • Number of pre-ART patients grows proportional to the number of ART patients • Pediatric ART proportion increases from 5.9% to 9.0% of total on ART by the end of FY2015 • Patients on 2nd line regimens increase from 0.6% to 4.8% of total on ART by the end of FY2015

  11. Estimated unit cost for ART and pre-ART patients • Average annual per patient costs of $202 for ART patients and $94 for pre-ART patients • Per patient costs expected to be relatively flat over the period of projection

  12. ART program scale-up trends in alternate scenarios 600,000 500,000 400,000 300,000 200,000 100,000 No. of ART patients

  13. Comparisons of trends in projected costs under different scenarios FY 2011 - 2015

  14. Conclusions • Cost projections facilitate informed planning • Projections offer options of ART scale-up • Current trend in patient uptake in Ethiopia fall short of attaining Universal Access by 2015

  15. Acknowledgments Nick Menzies – ICF MACRO Thomas Kenyon – CDC Ethiopia Zenebe Melaku – CU ICAP TsigeredaGadisa – CU ICAP Bill Graham – UW ITECH Getachew Feleke – UW ITECH Solomon Zewdu – JHU Misrak Makonnen – CRS/AIDSRelief Diana Mattanovich – UCSD Yoseph Mamo –UCSD Thomas Heller – CDC Ethiopia Cate McKinney – CDC Ethiopia Abubaker Bedri – CDC Ethiopia All CDC Ethiopia technical staff

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