A Botswana National Evaluation of Models of HIV/AIDS Care


Principal Investigator:
Richard Marlink, Bruce A. Beal, Robert L. Beal, and Alexander S. Beal Professor of the Practice of Public Health

HSPH AIDS Initiatives

Dates of Research:
September 1, 2007 — November 30, 2011


The Harvard School of Public Health AIDS Initiative (HAI) is currently finalizing a three-year cost-effectiveness study of the antiretroviral (ARV) treatment for HIV and AIDS in Botswana. The overall objective of this study is to determine the most cost-effective method of implementing the National ARV Therapy Programme. HAI now proposes to collaborate with the National AIDS Coordinating Agency to expand this study to identify the cost effectiveness and cost-savings of varying models of monitoring and evaluation (i.e. laboratory monitoring) and clinical care of HAART delivery. Objectives of this study include: (1) To assess the immunological, virological and clinical outcomes of ART under different models of clinical care and monitoring and evaluation. (2) To examine the cost implications associated with changes in health care resource utilization and human resource mix due to less intensive laboratory protocols and nurse-centered clinical care. (3) To examine the cost-effectiveness of varying clinical care and monitoring and evaluation protocols. The results of this study will inform debate regarding the long term financial sustainability of current monitoring and evaluation protocol and the feasibility of replicating the human and capital infrastructure in rural settings to sustain such protocol.