Smart Investments to Save Lives: Efficiencies, Innovation, Impact

On Thursday, February 10, 2011, PEPFAR held a one-day forum “Smart Investments to Save More Lives: Efficiencies, Innovation, Impact.” The meeting spotlighted PEPFAR’s work to gain greater impact and efficiency through smart investments in programs working to save lives from HIV/AIDS. This discussion built upon PEPFAR’s ongoing efforts to maximize the impact of every dollar spent. Please see the attached agenda for additional information.

Presentations from this meeting are available below.

Opening Remarks by Ambassador Eric Goosby, U.S. Global AIDS Coordinator

Driving Efficiency and Impact through the PEPFAR South Africa Partnership Framework
Dr. Mary Fanning, PEPFAR South Africa, discusses how PEPFAR's support of country ownership through a Partnership Framework and other country-level coordination has helped PEPFAR become more effective in saving lives in South Africa. PEPFAR Partnership Frameworks provide five-year joint strategic frameworks for cooperation between the U.S. Government, partner governments, and other partners to combat HIV/AIDS.

Partnering with PEPFAR to Improve Program Planning, ARV Procurement Policies, Government Investment, and Efficiency
Dr. Mark Blecher, Ministry of Finance, Republic of South Africa, and Dr. Yogan Pillay, Department of Health, Republic of South Africa, speak about the HIV epidemic in South Africa and how the partnership between PEPFAR and South Africa has led to increased efficiencies and the transition to a sustained domestic response.

Achieving Greater Impact and Efficiency through Partnerships in Botswana
Dr. Ndwapi Ndwapi, Botswana Ministry of Health, and Mr. Christopher O’Connell, PEPFAR Botswana, describe how the PEPFAR Partnership Framework with Botswana and related strategic coordination have helped align country goals and PEPFAR goals, clarifying roles for each partner. This coordination has led to sustainable cost savings and improved impact.

Using Cost Data to Improve Program Planning
Dr. Nalinee Sangrujee, CDC, describes how PEPFAR is accelerating the collection and use of cost and expenditure data to identify efficiencies in quality care and treatment service delivery models.

Innovations in Expenditure Tracking in Mozambique
Dr. Amy Dubois, CDC Mozambique, presents on how Mozambique is using costing data to inform budget and program planning to assure the efficient use of PEPFAR investments.

Innovations in Costing Health Care Delivery Models
Dr. Sydney Rosen, Boston University/ University of Witwatersrand explains how PEPFAR programs are achieving cost savings by caring for stable patients at lower-level health facilities and through nurse-initiated HIV treatment in South Africa and Zambia.

Strategic HIV and Health Systems Integration
Dr. Wafaa El Sadr, International Center for AIDS Care and Treatment Programs (ICAP), Columbia University, discusses how programmatic innovations such the strategic integration of TB and HIV services, and spillover effects of antiretroviral treatment such as increased economic productivity, are amplifying the impact of PEPFAR's investments.

Scaling-up TB/HIV Integration to Improve Outcomes
Dr. Greet Vandebriel, ICAP Rwanda, provides an overview of the partnership between the Rwandan Government and PEPFAR to scale up integrated TB/HIV services nationwide. Nearly all of the district hospitals and a majority of health centers in Rwanda now offer both TB and HIV services, and a study of HIV treatment clinics nationwide found that 90 percent of HIV-positive patients were screened for TB.

Integrating Prevention of Mother-to-Child Transmission with Maternal, Newborn and Child Health Programs
Dr. Anja Giphart, Elizabeth Glaser Pediatric AIDS Foundation, demonstrates how integrating the care of women and children with other services serves as an efficient and cost-effective strategy for improving maternal and child health in high HIV prevalence areas. Through strategic integration, health services can offer people the care they need, when they need it, in ways that reduce patient time and effort, achieve the desired results, and provide value for money.

Scaling Innovative Prevention Modalities: Medical Male Circumcision
Dr. Emmanuel Njeuhmeli, USAID, speaks about increasing prevention impact through male circumcision. With an upfront investment of about $1 billion to rapidly scale up male circumcision to an 80 percent coverage level, models show that about 20 percent of new HIV infections in Eastern and Southern Africa can be prevented, resulting in an estimated $20 billion in long-term care and treatment cost savings.

Using Information Technology to Reduce Human Resource Requirements and Improve Impact
Dr. Ian Sanne, Right to Care/University of Witwatersrand talks about how developments in technology, including mobile networks, IT infrastructure, and electronic medical records, are helping PEPFAR become more effective and efficient in the fight against global AIDS.

Leveraging Public-Private Partnerships: PEPFAR-BD Partnership to Expand Laboratory Capacity
Ms. Krista Thompson, Becton Dickinson, describes how PEPFAR is leveraging public-private partnerships to improve efficiencies in treatment, care, and support. For example, PEPFAR’s partnership with BD is helping to strengthen laboratory systems and quality improvement strategies in Africa, resulting in better diagnostics and improved training of health care workers.

Leveraging Public-Private Partnerships: PEPFAR-BD Partnership to Expand Laboratory Capacity
Dr. John Nkengesong, CDC, explains that the PEPFAR-BD public-private partnership has improved the quality of rapid testing for HIV and other infectious diseases, increased quality assurance, strengthened training facilities, improved access to tuberculosis diagnostics, and supported national reference laboratories for tuberculosis.

Efficiency Gains through Smarter Transportation and Pooled Procurement
Mr. David Jamieson, SCMS, explains how antiretroviral drugs purchased through the Supply Chain Management System, an organization established by PEPFAR and managed by USAID, are now over 98 percent generic, resulting in over $380 million saved in 2010 alone and allowing PEPFAR to provide treatment to more people. This system has also saved millions of dollars by moving HIV drugs and other supplies by sea and overland routes rather than by air.

Summary and Concluding Remarks
Dr. Charles Holmes, Office of the U.S. Global AIDS Coordinator, U.S. Department of State, summarizes PEPFAR’s plans to systematically address efficiency and impact at all levels of the HIV response, from intervention site, to program level, to national and broader systems levels.


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