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

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

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...

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Bibliographic Details
Main Authors:	Naning, Herlianna, Kerr, Cliff, Kamarulzaman, Adeeba, Osornprasop, Sutayut, Dahlui, Maznah, Ng, Chiu-Wan, Wilson, David P.
Language:	English en_US
Published:	Washington, DC 2014
Subjects:	ACQUIRED IMMUNE DEFICIENCY SYNDROME ACQUIRED IMMUNODEFICIENCY SYNDROME ADDICTION AID AMPHETAMINES ARI BLOOD TRANSFUSION CANCERS CAUSES OF DEATH CERVICAL CANCER CHILDHOOD CIRCUMCISION CITIZENS CLINICAL PROTOCOLS CLINICS CONDOMS COST EFFECTIVENESS CRIME CURRENT POPULATION DEATH RATE DEATH RATES DEATHS DECISION MAKING DEPENDANTS DEVELOPING COUNTRIES DIAGNOSES DISABILITY DISEASE DISEASE BURDEN DISEASE CONTROL DISEASE TRANSMISSION DRUG ADDICTION DRUG USERS DRUGS EPIDEMIC EPIDEMIOLOGY EXPENDITURES FEMALE GENDER GENERAL PRACTITIONER GENERIC DRUGS GLOBAL CONSENSUS GOVERNMENT AGENCIES GPS GROSS DOMESTIC PRODUCT HARM REDUCTION HEALTH CARE HEALTH CARE COSTS HEALTH CARE FACILITIES HEALTH CARE RESEARCH HEALTH CARE SERVICES HEALTH COSTS HEALTH FACILITIES HEALTH SECTOR HEALTH SERVICES HEALTH STRATEGY HEPATITIS HEPATITIS C HIV HIV INFECTION HIV INFECTIONS HIV POSITIVE HIV PREVENTION HIV TESTING HIV TRANSMISSION HIV/AIDS HOSPITAL HOSPITALS HUMAN IMMUNODEFICIENCY VIRUS HUMAN RESOURCES HYGIENE ILLNESS IMMUNE DEFICIENCY IMMUNODEFICIENCY IMPORTANT POLICY INCOME INFECTION RATE INFECTIOUS DISEASES INFORMATION SYSTEM INPATIENT CARE INTEGRATION INTERVENTION INTRAVENOUS DRUG USE ISOLATION JOB OPPORTUNITIES MALARIA MALES MEDICAL PRACTITIONERS METHADONE MINISTRY OF HEALTH MORBIDITY MORTALITY MOTHER MOTHER TO CHILD MOVEMENT OF PEOPLE NATIONAL AIDS NATIONAL DRUG NATIONAL LEVEL NATIONAL POLICY NUMBER OF NEW INFECTIONS NUMBER OF PEOPLE OPPORTUNISTIC INFECTIONS OUTPATIENT CARE OUTPATIENT SERVICES PAP SMEAR PATIENT PATIENTS POLICY DISCUSSIONS POPULATION DATA POPULATION SIZE PREVALENCE PREVENTION ACTIVITIES PRISONS PROBABILITY PROGRESS PUBLIC DEMAND PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH SERVICES PUBLIC SERVICES PUBLIC SUPPORT QUALITY OF LIFE QUALITY OF SERVICES REHABILITATION REHABILITATION CENTRES RESOURCE ALLOCATIONS RESOURCE NEEDS RESPECT SCREENING SERVICE PROVIDERS SEX SEX WITH MEN SEX WORKERS SOCIAL CONSEQUENCES SPECIALIST SYMPTOMS SYRINGES TB TECHNICAL ASSISTANCE THERAPIES THERAPY TREATMENT USER FEES VACCINATION VIRUS INFECTIONS VOLUNTARY COUNSELLING
Online Access:	http://documents.worldbank.org/curated/en/2014/01/19533085/return-investment-cost-effectiveness-harm-reduction-program-malaysia http://hdl.handle.net/10986/18641

Description
Summary:	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.

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

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