Setting Priorities for HIV/AIDS Interventions
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Setting Priorities for HIV/AIDS Interventions

A Cost–Benefit Approach

Robert J. Brent

HIV/AIDS is much too complex a phenomenon to be understood only by reference to common sense and ethical codes. This book presents the cost–benefit analysis (CBA) framework in a well-researched and accessible manner to ensure that the most important considerations are recognized and incorporated.
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Chapter 35: Value of a Statistical Life Practice: The Benefits of VCT

Robert J. Brent


In this chapter we will explain how the VSL approach has been used to value VCT services in Tanzania as covered in Brent (2009a). In that country, at the time of the evaluation, VCT services were available to a very small percentage of the population. One issue then, after carrying out a CBA of an existing program, is how to evaluate VCT programs if they were to be scaled up to the population as a whole. As we have seen in Part I, scaling up HIV/AIDS interventions is a main objective of UNAIDS and the World Bank. So we will be examining results for both existing and scaled up VCT programs in Tanzania. Because evaluating VCT completes our study of alternative methods for evaluating CBA interventions for HIV/AIDS, and as a kind of conclusion to Part III of this book, we will compare and contrast the VSL results for VCT with those using a competing benefit methodology, that is, the human capital (HC) approach. As usual, we begin the outline of a CBA application with a discussion of the effectiveness of the intervention. ESTIMATING VCT EFFECTIVENESS We will start with a framework that provides estimates of the number of lives saved if we assume that VCT is effective. Then we refer to evidence supporting this assumption for Tanzania. VCT services involve testing, and then counseling on the basis of the test results, to change behavior. The effectiveness of the services depends crucially on the existence of discordant couples – couples where...

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