Standard cost-effectiveness analyses compare the investment made in a programme to its HIV benefit alone. But by intervening “upstream”, structural programmes are likely to have multiple other health and development objectives and benefits. Evaluating the value-for-money of this kind of intervention therefore requires a broad cross-sectoral perspective. The HIV sector could, for example, co-finance such interventions with other benefiting sectors. In this scenario, value-for-money would be assessed on the contribution of each sector, rather than on the full cost of the intervention.
Michelle Remme is a research fellow in health economics at the London School of Hygiene and Tropical Medicine. She has worked for eight years on the economics of HIV and health financing within the United Nations system (FAO, WHO, World Bank), the Dutch Government, and consultancy and research institutions at the international and country level. Her main research focus is on HIV financing, efficiency and, more specifically, resource-allocation decision-making on interventions with multiple cross-sectoral outcomes.
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