Scaling up antiretroviral treatment in the public sector in Nigeria : a comprehensive analysis of resource requirements

KOMBE, Gilbert

Publication Date 

February 2004
27 p

This report presents estimates of the total cost of providing comprehensive antiretroviral (ARV) treatment in the public sector in Nigeria, using the AIDSTREATCOST model to estimate the cost of providing Highly Active Antiretroviral Therapy (HAART), voluntary counseling and testing, and opportunistic infection (OI) treatment, and other resource requirements for implementing the national antiretroviral treatment programme. Drugs are not the only major cost of an ARV programme, but they are the largest single component ($368, or 50 percent of the total annual programme cost per patient); monitoring tests account for 23 percent and labor costs for 22 percent of total programme costs. A large proportion of current treatment costs is borne by the patient -- $170 per year for monitoring and a further $86 for their contribution to ARV drugs. This is equivalent to almost 75 percent of per capita GDP and therefore well beyond the resources of most Nigerians. Patients also are expected to pay for VCT services ($11), and for OI treatment costs when these arise. The development of an effective ARV programme, therefore, must include support not only for ARV drugs but all aspects of patient cost. The report also examines financial and human resources requirements for achieving the World Health Organization-recommended targets and recommends a number of strategies for the government and development partners to consider regarding program expansion, human resources training and requirements, support for VCT, the high cost of monitoring tests, and drug cost

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