Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia

Naning, Herlianna; Kerr, Cliff; Kamarulzaman, Adeeba; Osornprasop, Sutayut; Dahlui, Maznah; Ng, Chiu-Wan; Wilson, David P.

Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia

2014

Cases of human immunodeficiency virus (HIV) infections were first detected in Malaysia in 1986. Since then, the number of new HIV cases has been increasing steadily to a peak of 6,978 new cases detected in 2002 then declining to 3,438 new cases in 2012. In response to the escalating epidemic, the Government of Malaysia (GOM) agreed the implementation of needle syringe program (NSP) and methadone maintenance therapy (MMT) programs against much public opposition which viewed these programs as being against the Islamic religion and will encourage more people to use drugs. The main objectives of this study are to evaluate whether the harm reduction program in Malaysia is cost-effective and also whether they provide return on investments (ROIs) to the government. The study used an epidemiologic mathematical model of HIV transmission and disease progression, called the projection and evaluation tool (Prevtool) developed by a team of investigators at the Kirby Institute, University of New South Wales, Australia to simulate the impact of MMT and NSP on the transmission of HIV among people who inject drugs (PWIDs) in Malaysia. Briefly, the model simulates the number of PWID who become infected with HIV over time as well as the extent of disease progression among those infected in the presence and absence of harm reduction program in the country. This study has shown that the combined MMT and NSP programs as implemented in Malaysia are cost-effective and are expected to produce net cost-savings to the government in the future. Evidence of cost-effectiveness and expected cost-savings support policy recommendation that both MMT and NSP programs should be maintained as part of the key strategy to control HIV spread among PWIDs in Malaysia. Study findings that even with the present program coverage, harm reduction activities are expected to become more cost-effective and cost-saving in the future suggest that policies towards program expansion may demonstrate higher value for money.

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AGROVOC Keywords

acquired immunodeficiency syndrome aids crime death rate decision making developing countries disease control disease transmission drugs epidemiology gender government agencies gps gross domestic product health care health services hepatitis hiv hiv infections hospital hospitals human immunodeficiency virus human resources hygiene immune deficiency immunodeficiency income infectious diseases integration isolation malaria males morbidity mortality patient patients public health public services quality of life rehabilitation screening sex symptoms therapy vaccination

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Washington, DC

Other Subjects

Rehabilitation centres; Intervention; Hiv prevention; Social consequences; Health care facilities; National level; Citizens; Public demand; Health costs; Epidemic; Pap smear; Virus infections; Circumcision; Hepatitis c; Prisons; Service providers; Progress; Health care research; Specialist; Sex with men; Population size; Drug users; Sex workers; Outpatient care; Illness; Expenditures; Resource needs; Current population; Ministry of health; Public health care; Blood transfusion; Resource allocations; Infection rate; Treatment; Methadone; Disease burden; Health sector; Dependants; Prevention activities; Amphetamines; Quality of services; Population data; Therapies; Cervical cancer; Diagnoses; Voluntary counselling; Public support; Movement of people; Health care services; Technical assistance; Number of people; Death rates; Generic drugs; Hiv infection; Harm reduction; National aids; Policy discussions; Inpatient care; Hiv testing; National drug; Information system; Childhood; Aid; Cancers; Respect; Health care costs; Mother; Disease; Disability; Hiv transmission; Clinics; National policy; Public health services; General practitioner; Cost effectiveness; Job opportunities; Number of new infections; Intravenous drug use; Global consensus; Female; Probability; Drug addiction; Causes of death; Health facilities; Acquired immune deficiency syndrome; Syringes; Condoms; Ari; Clinical protocols; Important policy; User fees; Medical practitioners; Health strategy; Outpatient services; Opportunistic infections; Mother to child; Hiv positive; Deaths; Addiction; Prevalence

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http://hdl.handle.net/10986/18641http://creativecommons.org/licenses/by/3.0/igo/CC BY 3.0 IGO

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Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia

2014

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