Financing equitable access to antiretroviral treatment in South Africa

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dc.contributor.authorCleary, Susanen_ZA
dc.contributor.authorMcIntyre, Dien_ZA
dc.date.accessioned2015-10-30T09:28:29Z
dc.date.available2015-10-30T09:28:29Z
dc.date.issued2010en_ZA
dc.description.abstractBACKGROUND:While South Africa spends approximately 7.4% of GDP on healthcare, only 43% of these funds are spent in the public system, which is tasked with the provision of care to the majority of the population including a large proportion of those in need of antiretroviral treatment (ART). South Africa is currently debating the introduction of a National Health Insurance (NHI) system. Because such a universal health system could mean increased public healthcare funding and improved access to human resources, it could improve the sustainability of ART provision. This paper considers the minimum resources that would be required to achieve the proposed universal health system and contrasts these with the costs of scaled up access to ART between 2010 and 2020. METHODS: The costs of ART and universal coverage (UC) are assessed through multiplying unit costs, utilization and estimates of the population in need during each year of the planning cycle. Costs are from the provider's perspective reflected in real 2007 prices. RESULTS: The annual costs of providing ART increase from US$1 billion in 2010 to US$3.6 billion in 2020. If increases in funding to public healthcare only keep pace with projected real GDP growth, then close to 30% of these resources would be required for ART by 2020. However, an increase in the public healthcare resource envelope from 3.2% to 5%-6% of GDP would be sufficient to finance both ART and other services under a universal system (if based on a largely public sector model) and the annual costs of ART would not exceed 15% of the universal health system budget. CONCLUSIONS: Responding to the HIV-epidemic is one of the many challenges currently facing South Africa. Whether this response becomes a "resource for democracy" or whether it undermines social cohesiveness within poor communities and between rich and poor communities will be partially determined by the steps that are taken during the next ten years. While the introduction of a universal system will be complex, it could generate a health system responsive to the needs of all South Africans.en_ZA
dc.identifier.apacitationCleary, S., & McIntyre, D. (2010). Financing equitable access to antiretroviral treatment in South Africa. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/14501en_ZA
dc.identifier.chicagocitationCleary, Susan, and Di McIntyre "Financing equitable access to antiretroviral treatment in South Africa." <i>BMC Health Services Research</i> (2010) http://hdl.handle.net/11427/14501en_ZA
dc.identifier.citationCleary, S., & McIntyre, D. (2010). Financing equitable access to antiretroviral treatment in South Africa. BMC health services research, 10(Suppl 1), S2.en_ZA
dc.identifier.ris TY - Journal Article AU - Cleary, Susan AU - McIntyre, Di AB - BACKGROUND:While South Africa spends approximately 7.4% of GDP on healthcare, only 43% of these funds are spent in the public system, which is tasked with the provision of care to the majority of the population including a large proportion of those in need of antiretroviral treatment (ART). South Africa is currently debating the introduction of a National Health Insurance (NHI) system. Because such a universal health system could mean increased public healthcare funding and improved access to human resources, it could improve the sustainability of ART provision. This paper considers the minimum resources that would be required to achieve the proposed universal health system and contrasts these with the costs of scaled up access to ART between 2010 and 2020. METHODS: The costs of ART and universal coverage (UC) are assessed through multiplying unit costs, utilization and estimates of the population in need during each year of the planning cycle. Costs are from the provider's perspective reflected in real 2007 prices. RESULTS: The annual costs of providing ART increase from US$1 billion in 2010 to US$3.6 billion in 2020. If increases in funding to public healthcare only keep pace with projected real GDP growth, then close to 30% of these resources would be required for ART by 2020. However, an increase in the public healthcare resource envelope from 3.2% to 5%-6% of GDP would be sufficient to finance both ART and other services under a universal system (if based on a largely public sector model) and the annual costs of ART would not exceed 15% of the universal health system budget. CONCLUSIONS: Responding to the HIV-epidemic is one of the many challenges currently facing South Africa. Whether this response becomes a "resource for democracy" or whether it undermines social cohesiveness within poor communities and between rich and poor communities will be partially determined by the steps that are taken during the next ten years. While the introduction of a universal system will be complex, it could generate a health system responsive to the needs of all South Africans. DA - 2010 DB - OpenUCT DO - 10.1186/1472-6963-10-S1-S2 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Financing equitable access to antiretroviral treatment in South Africa TI - Financing equitable access to antiretroviral treatment in South Africa UR - http://hdl.handle.net/11427/14501 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14501
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6963-10-S1-S2
dc.identifier.vancouvercitationCleary S, McIntyre D. Financing equitable access to antiretroviral treatment in South Africa. BMC Health Services Research. 2010; http://hdl.handle.net/11427/14501.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2010 Cleary and McIntyre; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Health Services Researchen_ZA
dc.source.urihttp://www.biomedcentral.com/bmchealthservres/en_ZA
dc.subject.otherHealth Economicsen_ZA
dc.subject.otherHealth Services Accessibilityen_ZA
dc.subject.otherAnti-Retroviral Agentsen_ZA
dc.subject.otherHIV Infectionsen_ZA
dc.titleFinancing equitable access to antiretroviral treatment in South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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