The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa
HIV prevalence in Southern Africa is the highest in the world and the impact of HIV/AIDS in the region are devastating at all levels of society, including the wider economy. Government response has lagged behind the pace of the epidemic, but progra...
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2014
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| Online Access: | http://documents.worldbank.org/curated/en/2003/02/2160787/strategic-use-potential-demand-hiv-vaccine-southern-africa http://hdl.handle.net/10986/19153 |
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okr-10986-19153 |
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| recordtype |
oai_dc |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
HIV INFECTIONS HIV VIRUS TESTING HIV VIRUSES VACCINES VACCINATION COMMERCIAL SEX WORKERS SCHOOL CHILDREN DISEASE PREVENTION DISEASE PREVENTION & CONTROL DISEASE TREATMENT WILLINGNESS TO PAY DISEASE TREATMENT DISEASE TRANSMISSION DISEASE SURVEILLANCE ADULT MORTALITY ADULT POPULATION ADULT PREVALENCE ADULT PREVALENCE RATES AGED AIDS DEATHS AIDS PATIENTS AIDS TREATMENT AIDS VACCINE ANTENATAL CLINICS BEHAVIOR CHANGE BREASTFEEDING CASES OF HIV CHILD MORTALITY CLINICAL RESEARCH CLINICS COMMERCIAL SEX COMMERCIAL SEX WORKER COMMERCIAL SEX WORKERS CONDOM USE CONDOMS COST EFFECTIVENESS CROWDING CULTURAL ENVIRONMENT DEVELOPMENT INDICATORS ECONOMICS EXPENDITURES GIRLS GROUPS HEALTH CARE HEALTH SERVICES HEALTH WORKERS HIGH RISK GROUPS HIGH-RISK HIGH-RISK GROUPS HIV HIV INFECTION HIV POSITIVE HIV PREVALENCE HIV VIRUS IMMUNITY INCIDENCE OF HIV INCOME INFANT MORTALITY INFECTIONS INTERVENTION LIFE EXPECTANCY LIFE SKILLS LOSS OF SKILLS LOW PREVALENCE MEDIA MEDICAL CARE MEDICAL RESEARCH MIGRANTS MORALITY MORBIDITY MORTALITY MORTALITY RATE MOTIVATION NUMBER OF AIDS DEATHS PATIENTS PERCEPTIONS OF RISK POLICY RESEARCH PUBLIC SERVICES RISK RISK GROUPS SCREENING SEX WORKERS SEXUAL ACTIVITY SEXUAL BEHAVIOR SEXUAL BEHAVIORS SEXUAL CONTACT SEXUAL CONTACTS SEXUAL PARTNERS SEXUAL RISK SEXUAL RISK BEHAVIOR SEXUALITY SOCIAL SERVICES SPREAD OF HIV TRANSMISSION TUBERCULOSIS UNAIDS URBAN AREAS USE OF CONDOMS VACCINATION VACCINATIONS VACCINES VOLUNTARY COUNSELLING VULNERABLE GROUPS WORKFORCE YOUNG ADULTS |
| spellingShingle |
HIV INFECTIONS HIV VIRUS TESTING HIV VIRUSES VACCINES VACCINATION COMMERCIAL SEX WORKERS SCHOOL CHILDREN DISEASE PREVENTION DISEASE PREVENTION & CONTROL DISEASE TREATMENT WILLINGNESS TO PAY DISEASE TREATMENT DISEASE TRANSMISSION DISEASE SURVEILLANCE ADULT MORTALITY ADULT POPULATION ADULT PREVALENCE ADULT PREVALENCE RATES AGED AIDS DEATHS AIDS PATIENTS AIDS TREATMENT AIDS VACCINE ANTENATAL CLINICS BEHAVIOR CHANGE BREASTFEEDING CASES OF HIV CHILD MORTALITY CLINICAL RESEARCH CLINICS COMMERCIAL SEX COMMERCIAL SEX WORKER COMMERCIAL SEX WORKERS CONDOM USE CONDOMS COST EFFECTIVENESS CROWDING CULTURAL ENVIRONMENT DEVELOPMENT INDICATORS ECONOMICS EXPENDITURES GIRLS GROUPS HEALTH CARE HEALTH SERVICES HEALTH WORKERS HIGH RISK GROUPS HIGH-RISK HIGH-RISK GROUPS HIV HIV INFECTION HIV POSITIVE HIV PREVALENCE HIV VIRUS IMMUNITY INCIDENCE OF HIV INCOME INFANT MORTALITY INFECTIONS INTERVENTION LIFE EXPECTANCY LIFE SKILLS LOSS OF SKILLS LOW PREVALENCE MEDIA MEDICAL CARE MEDICAL RESEARCH MIGRANTS MORALITY MORBIDITY MORTALITY MORTALITY RATE MOTIVATION NUMBER OF AIDS DEATHS PATIENTS PERCEPTIONS OF RISK POLICY RESEARCH PUBLIC SERVICES RISK RISK GROUPS SCREENING SEX WORKERS SEXUAL ACTIVITY SEXUAL BEHAVIOR SEXUAL BEHAVIORS SEXUAL CONTACT SEXUAL CONTACTS SEXUAL PARTNERS SEXUAL RISK SEXUAL RISK BEHAVIOR SEXUALITY SOCIAL SERVICES SPREAD OF HIV TRANSMISSION TUBERCULOSIS UNAIDS URBAN AREAS USE OF CONDOMS VACCINATION VACCINATIONS VACCINES VOLUNTARY COUNSELLING VULNERABLE GROUPS WORKFORCE YOUNG ADULTS Desmond, Christopher Greener, Robert The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa |
| geographic_facet |
Africa Southern Africa |
| relation |
Policy Research Working Paper;No. 2977 |
| description |
HIV prevalence in Southern Africa is the
highest in the world and the impact of HIV/AIDS in the
region are devastating at all levels of society, including
the wider economy. Government response has lagged behind the
pace of the epidemic, but programs are now beginning to
focus on a broad range of interventions to combat its
further spread and to mitigate its impact. The authors
investigate the issues around the targeting of an eventual
HIV vaccine. There is at present no vaccine against HIV.
Although several candidates are in the trial stage, it is
not likely that a vaccine effective against the sub-type of
the virus prevalent in Southern Africa will be available for
10-15 years. When it is, it may be expensive, only partially
effective, and confer immunity for a limited period only.
Vaccination programs will need to make the best use of the
vaccine that is available and effective targeting will be
essential. The authors identify potential target groups for
a vaccine, and estimate how many individuals would be in
need of vaccination. They develop a method for estimating
how many cases of HIV infection are likely to be avoided for
each vaccinated individual. The cases avoided are of two
kinds: primary-the individual case that might have occurred
in people who are vaccinated, and secondary-the number of
people that the vaccinated individual would otherwise have
caused to become infected. Both of these depend on
assumptions about the efficacy and duration of vaccine
protection and the extent and nature of sexual risk behavior
in the population groups. The authors distinguish between
the HIV cases averted per vaccination and the cases averted
per 100 recruits into a vaccination program. The cases
averted per 100 recruits is used to develop a priority
ranking of the identified population groups for vaccination.
The authors discuss the issue of ease of access to those
groups and how the differential costs would affect the
vaccination strategy. They conclude that an expensive
vaccine should be administered to commercial sex workers
first, while an inexpensive vaccine would be better
administered first to general population groups, in
particular, schoolchildren. The authors conclude with a
discussion of current levels of public and private
expenditure on HIV prevention and treatment, and the
implications for an assessment of the willingness to pay for
an eventual HIV vaccine. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
Desmond, Christopher Greener, Robert |
| author_facet |
Desmond, Christopher Greener, Robert |
| author_sort |
Desmond, Christopher |
| title |
The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa |
| title_short |
The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa |
| title_full |
The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa |
| title_fullStr |
The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa |
| title_full_unstemmed |
The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa |
| title_sort |
strategic use and potential demand for an hiv vaccine in southern africa |
| publisher |
World Bank, Washington, DC |
| publishDate |
2014 |
| url |
http://documents.worldbank.org/curated/en/2003/02/2160787/strategic-use-potential-demand-hiv-vaccine-southern-africa http://hdl.handle.net/10986/19153 |
| _version_ |
1764439207109984256 |
| spelling |
okr-10986-191532021-04-23T14:03:42Z The Strategic Use and Potential Demand for an HIV Vaccine in Southern Africa Desmond, Christopher Greener, Robert HIV INFECTIONS HIV VIRUS TESTING HIV VIRUSES VACCINES VACCINATION COMMERCIAL SEX WORKERS SCHOOL CHILDREN DISEASE PREVENTION DISEASE PREVENTION & CONTROL DISEASE TREATMENT WILLINGNESS TO PAY DISEASE TREATMENT DISEASE TRANSMISSION DISEASE SURVEILLANCE ADULT MORTALITY ADULT POPULATION ADULT PREVALENCE ADULT PREVALENCE RATES AGED AIDS DEATHS AIDS PATIENTS AIDS TREATMENT AIDS VACCINE ANTENATAL CLINICS BEHAVIOR CHANGE BREASTFEEDING CASES OF HIV CHILD MORTALITY CLINICAL RESEARCH CLINICS COMMERCIAL SEX COMMERCIAL SEX WORKER COMMERCIAL SEX WORKERS CONDOM USE CONDOMS COST EFFECTIVENESS CROWDING CULTURAL ENVIRONMENT DEVELOPMENT INDICATORS ECONOMICS EXPENDITURES GIRLS GROUPS HEALTH CARE HEALTH SERVICES HEALTH WORKERS HIGH RISK GROUPS HIGH-RISK HIGH-RISK GROUPS HIV HIV INFECTION HIV POSITIVE HIV PREVALENCE HIV VIRUS IMMUNITY INCIDENCE OF HIV INCOME INFANT MORTALITY INFECTIONS INTERVENTION LIFE EXPECTANCY LIFE SKILLS LOSS OF SKILLS LOW PREVALENCE MEDIA MEDICAL CARE MEDICAL RESEARCH MIGRANTS MORALITY MORBIDITY MORTALITY MORTALITY RATE MOTIVATION NUMBER OF AIDS DEATHS PATIENTS PERCEPTIONS OF RISK POLICY RESEARCH PUBLIC SERVICES RISK RISK GROUPS SCREENING SEX WORKERS SEXUAL ACTIVITY SEXUAL BEHAVIOR SEXUAL BEHAVIORS SEXUAL CONTACT SEXUAL CONTACTS SEXUAL PARTNERS SEXUAL RISK SEXUAL RISK BEHAVIOR SEXUALITY SOCIAL SERVICES SPREAD OF HIV TRANSMISSION TUBERCULOSIS UNAIDS URBAN AREAS USE OF CONDOMS VACCINATION VACCINATIONS VACCINES VOLUNTARY COUNSELLING VULNERABLE GROUPS WORKFORCE YOUNG ADULTS HIV prevalence in Southern Africa is the highest in the world and the impact of HIV/AIDS in the region are devastating at all levels of society, including the wider economy. Government response has lagged behind the pace of the epidemic, but programs are now beginning to focus on a broad range of interventions to combat its further spread and to mitigate its impact. The authors investigate the issues around the targeting of an eventual HIV vaccine. There is at present no vaccine against HIV. Although several candidates are in the trial stage, it is not likely that a vaccine effective against the sub-type of the virus prevalent in Southern Africa will be available for 10-15 years. When it is, it may be expensive, only partially effective, and confer immunity for a limited period only. Vaccination programs will need to make the best use of the vaccine that is available and effective targeting will be essential. The authors identify potential target groups for a vaccine, and estimate how many individuals would be in need of vaccination. They develop a method for estimating how many cases of HIV infection are likely to be avoided for each vaccinated individual. The cases avoided are of two kinds: primary-the individual case that might have occurred in people who are vaccinated, and secondary-the number of people that the vaccinated individual would otherwise have caused to become infected. Both of these depend on assumptions about the efficacy and duration of vaccine protection and the extent and nature of sexual risk behavior in the population groups. The authors distinguish between the HIV cases averted per vaccination and the cases averted per 100 recruits into a vaccination program. The cases averted per 100 recruits is used to develop a priority ranking of the identified population groups for vaccination. The authors discuss the issue of ease of access to those groups and how the differential costs would affect the vaccination strategy. They conclude that an expensive vaccine should be administered to commercial sex workers first, while an inexpensive vaccine would be better administered first to general population groups, in particular, schoolchildren. The authors conclude with a discussion of current levels of public and private expenditure on HIV prevention and treatment, and the implications for an assessment of the willingness to pay for an eventual HIV vaccine. 2014-07-31T21:25:53Z 2014-07-31T21:25:53Z 2003-02 http://documents.worldbank.org/curated/en/2003/02/2160787/strategic-use-potential-demand-hiv-vaccine-southern-africa http://hdl.handle.net/10986/19153 English en_US Policy Research Working Paper;No. 2977 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research Africa Southern Africa |