The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries
Many people see an effective preventive AIDS vaccine as the best solution to the HIV/AIDS pandemic. Ten years ago many scientists had hoped that a vaccine would be available by now. Most scientists are still optimistic that vaccines will be develop...
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
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World Bank, Washington, D.C.
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2002/03/1744002/epidemiological-impact-hivaids-vaccine-developing-countries http://hdl.handle.net/10986/14818 |
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okr-10986-14818 |
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oai_dc |
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Digital Repository |
| institution_category |
Foreign Institution |
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Digital Repositories |
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World Bank Open Knowledge Repository |
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World Bank |
| language |
English en_US |
| topic |
ADOLESCENCE ADOLESCENT ADULT POPULATION AGED AIDS EPIDEMIC AIDS VACCINE AIDS VACCINES ANTENATAL CLINIC ANTENATAL CLINICS BEHAVIOR CHANGE BEHAVIOUR CHANGE CASUAL SEX CHILD TRANSMISSION CIRCUMCISION CLINICAL TRIALS CLINICS COMMERCIAL SEX COMMERCIAL SEX WORKERS COMMUNICABLE DISEASES CONDOM USE COST EFFECTIVENESS ECONOMICS EFFECTIVE VACCINES EPIDEMICS EPIDEMIOLOGY EXERCISES HARM REDUCTION HEALTH POLICY HETEROSEXUAL CONTACT HIGH-RISK HIGH-RISK GROUPS HIGH-RISK POPULATIONS HIV HIV INFECTION HIV PREVENTION HIV PREVENTION INTERVENTIONS HIV TRANSMISSION HIV VACCINATION IMMUNE SYSTEM IMMUNITY IMMUNIZATION INJECTING DRUG USE INTERVENTION LOW PREVALENCE MARITAL STATUS MORTALITY MORTALITY RATES NEW INFECTIONS OLDER ADULTS PANDEMIC PERINATAL TRANSMISSION POLICY RESEARCH POPULATION GROWTH PREGNANT WOMEN PREVENTION INTERVENTIONS PUBLIC HEALTH PUBLIC SERVICES REPRODUCTIVE AGE RESPONSE TO AIDS RISK FOR INFECTION RISK OF INFECTION RISK POPULATIONS SAFE SEX SEXUAL ACTIVITY SEXUAL PARTNERS SEXUAL RISK SEXUALLY TRANSMITTED DISEASES TEENAGERS TRANSMISSION UNAIDS UNPROTECTED SEX UNSAFE SEX USE OF DRUGS VACCINATION PROGRAMS VACCINATIONS VACCINES VIRAL LOAD WORLD HEALTH ORGANIZATION YOUNG ADULTS ACQUIRED IMMUNE DEFICIENCY SYNDROME VACCINES; HIV INFECTIONS; EPIDEMIOLOGY; COST EFFECTIVENESS; DISEASE PREVENTION; DISEASE TREATMENT; DURATION; SUBSIDIES; VULNERABLE GROUPS; CONDOMS; BEHAVIOR; WILLINGNESS TO PAY |
| spellingShingle |
ADOLESCENCE ADOLESCENT ADULT POPULATION AGED AIDS EPIDEMIC AIDS VACCINE AIDS VACCINES ANTENATAL CLINIC ANTENATAL CLINICS BEHAVIOR CHANGE BEHAVIOUR CHANGE CASUAL SEX CHILD TRANSMISSION CIRCUMCISION CLINICAL TRIALS CLINICS COMMERCIAL SEX COMMERCIAL SEX WORKERS COMMUNICABLE DISEASES CONDOM USE COST EFFECTIVENESS ECONOMICS EFFECTIVE VACCINES EPIDEMICS EPIDEMIOLOGY EXERCISES HARM REDUCTION HEALTH POLICY HETEROSEXUAL CONTACT HIGH-RISK HIGH-RISK GROUPS HIGH-RISK POPULATIONS HIV HIV INFECTION HIV PREVENTION HIV PREVENTION INTERVENTIONS HIV TRANSMISSION HIV VACCINATION IMMUNE SYSTEM IMMUNITY IMMUNIZATION INJECTING DRUG USE INTERVENTION LOW PREVALENCE MARITAL STATUS MORTALITY MORTALITY RATES NEW INFECTIONS OLDER ADULTS PANDEMIC PERINATAL TRANSMISSION POLICY RESEARCH POPULATION GROWTH PREGNANT WOMEN PREVENTION INTERVENTIONS PUBLIC HEALTH PUBLIC SERVICES REPRODUCTIVE AGE RESPONSE TO AIDS RISK FOR INFECTION RISK OF INFECTION RISK POPULATIONS SAFE SEX SEXUAL ACTIVITY SEXUAL PARTNERS SEXUAL RISK SEXUALLY TRANSMITTED DISEASES TEENAGERS TRANSMISSION UNAIDS UNPROTECTED SEX UNSAFE SEX USE OF DRUGS VACCINATION PROGRAMS VACCINATIONS VACCINES VIRAL LOAD WORLD HEALTH ORGANIZATION YOUNG ADULTS ACQUIRED IMMUNE DEFICIENCY SYNDROME VACCINES; HIV INFECTIONS; EPIDEMIOLOGY; COST EFFECTIVENESS; DISEASE PREVENTION; DISEASE TREATMENT; DURATION; SUBSIDIES; VULNERABLE GROUPS; CONDOMS; BEHAVIOR; WILLINGNESS TO PAY Stover, John Garnett, Geoff P. Seitz, Steve Forsythe, Steven The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries |
| geographic_facet |
Africa East Asia and Pacific |
| relation |
Policy Research Working Paper;No.2811 |
| description |
Many people see an effective preventive
AIDS vaccine as the best solution to the HIV/AIDS pandemic.
Ten years ago many scientists had hoped that a vaccine would
be available by now. Most scientists are still optimistic
that vaccines will be developed and many candidates are
being tested. Strategies to implement HIV/AIDS vaccination
need to be developed to be ready when vaccines do become
available. The nature of those programs will depend on the
characteristics of each vaccine. How much does it cost? How
effective is it? How long does protection last? The answers
to these and other questions will help determine issues such
as: What will be the impact of the vaccine on the epidemic?
Who should be vaccinated? Will an AIDS vaccine be more
cost-effective than other prevention measures? Will other
measures still be necessary? What will happen to the
epidemic if vaccination leads to riskier behavior? How much
funding will be needed? The authors use two computer
simulation models to investigate the effects of various
vaccine characteristics and implementation strategies on the
impact and cost-effectiveness of vaccines in different
contexts. A simulation model is applied to data from rural
Zimbabwe and the iwgAIDS model is applied to Kampala
(Uganda) and Thailand. The models are used to investigate
the effects of efficacy, duration, cost, and type of
protection on impact and cost-effectiveness. The models also
show the merits of targeting public subsidies to various
population groups: all adults, teenagers, high-risk groups,
and women of reproductive age. The impact of vaccines on the
epidemic is compared with the impact of other prevention
interventions such as condom use and behavior change.
Finally, the models are used to explore the extent with
which behavioral reversals may erode the positive benefits
of the vaccine. A highly effective, long-lasting,
inexpensive vaccine would be ideal and could make a major
contribution in controlling the HIV/AIDS pandemic. But
vaccines that do not attain this ideal can still be useful.
A vaccine with 50 percent efficacy and 10 years duration
supplied to 65 percent of all adults could reduce HIV
incidence by 25 to 60 percent, depending on the context and
stage of the epidemic. Better efficacy and longer duration
would provide even more impact. Programs focused on
teenagers or high-risk populations have less overall impact
but would provide significant benefits at much less cost
than those reaching all adults. Behavioral reversals could
erode much of the benefits of vaccination programs so it
will be important to combine vaccination with continued
messages about the importance of safe behaviors. The cost of
the vaccines is not known at this time. At a cost of $10 or
$20 per person vaccinated, the cost per infection averted
would be as low or lower than other prevention
interventions. Higher costs for the vaccines and the need
for many booster shots could reduce the cost-effectiveness significantly. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
Stover, John Garnett, Geoff P. Seitz, Steve Forsythe, Steven |
| author_facet |
Stover, John Garnett, Geoff P. Seitz, Steve Forsythe, Steven |
| author_sort |
Stover, John |
| title |
The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries |
| title_short |
The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries |
| title_full |
The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries |
| title_fullStr |
The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries |
| title_full_unstemmed |
The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries |
| title_sort |
epidemiological impact of an hiv/aids vaccine in developing countries |
| publisher |
World Bank, Washington, D.C. |
| publishDate |
2013 |
| url |
http://documents.worldbank.org/curated/en/2002/03/1744002/epidemiological-impact-hivaids-vaccine-developing-countries http://hdl.handle.net/10986/14818 |
| _version_ |
1764429651706380288 |
| spelling |
okr-10986-148182021-04-23T14:03:20Z The Epidemiological Impact of an HIV/AIDS Vaccine in Developing Countries Stover, John Garnett, Geoff P. Seitz, Steve Forsythe, Steven ADOLESCENCE ADOLESCENT ADULT POPULATION AGED AIDS EPIDEMIC AIDS VACCINE AIDS VACCINES ANTENATAL CLINIC ANTENATAL CLINICS BEHAVIOR CHANGE BEHAVIOUR CHANGE CASUAL SEX CHILD TRANSMISSION CIRCUMCISION CLINICAL TRIALS CLINICS COMMERCIAL SEX COMMERCIAL SEX WORKERS COMMUNICABLE DISEASES CONDOM USE COST EFFECTIVENESS ECONOMICS EFFECTIVE VACCINES EPIDEMICS EPIDEMIOLOGY EXERCISES HARM REDUCTION HEALTH POLICY HETEROSEXUAL CONTACT HIGH-RISK HIGH-RISK GROUPS HIGH-RISK POPULATIONS HIV HIV INFECTION HIV PREVENTION HIV PREVENTION INTERVENTIONS HIV TRANSMISSION HIV VACCINATION IMMUNE SYSTEM IMMUNITY IMMUNIZATION INJECTING DRUG USE INTERVENTION LOW PREVALENCE MARITAL STATUS MORTALITY MORTALITY RATES NEW INFECTIONS OLDER ADULTS PANDEMIC PERINATAL TRANSMISSION POLICY RESEARCH POPULATION GROWTH PREGNANT WOMEN PREVENTION INTERVENTIONS PUBLIC HEALTH PUBLIC SERVICES REPRODUCTIVE AGE RESPONSE TO AIDS RISK FOR INFECTION RISK OF INFECTION RISK POPULATIONS SAFE SEX SEXUAL ACTIVITY SEXUAL PARTNERS SEXUAL RISK SEXUALLY TRANSMITTED DISEASES TEENAGERS TRANSMISSION UNAIDS UNPROTECTED SEX UNSAFE SEX USE OF DRUGS VACCINATION PROGRAMS VACCINATIONS VACCINES VIRAL LOAD WORLD HEALTH ORGANIZATION YOUNG ADULTS ACQUIRED IMMUNE DEFICIENCY SYNDROME VACCINES; HIV INFECTIONS; EPIDEMIOLOGY; COST EFFECTIVENESS; DISEASE PREVENTION; DISEASE TREATMENT; DURATION; SUBSIDIES; VULNERABLE GROUPS; CONDOMS; BEHAVIOR; WILLINGNESS TO PAY Many people see an effective preventive AIDS vaccine as the best solution to the HIV/AIDS pandemic. Ten years ago many scientists had hoped that a vaccine would be available by now. Most scientists are still optimistic that vaccines will be developed and many candidates are being tested. Strategies to implement HIV/AIDS vaccination need to be developed to be ready when vaccines do become available. The nature of those programs will depend on the characteristics of each vaccine. How much does it cost? How effective is it? How long does protection last? The answers to these and other questions will help determine issues such as: What will be the impact of the vaccine on the epidemic? Who should be vaccinated? Will an AIDS vaccine be more cost-effective than other prevention measures? Will other measures still be necessary? What will happen to the epidemic if vaccination leads to riskier behavior? How much funding will be needed? The authors use two computer simulation models to investigate the effects of various vaccine characteristics and implementation strategies on the impact and cost-effectiveness of vaccines in different contexts. A simulation model is applied to data from rural Zimbabwe and the iwgAIDS model is applied to Kampala (Uganda) and Thailand. The models are used to investigate the effects of efficacy, duration, cost, and type of protection on impact and cost-effectiveness. The models also show the merits of targeting public subsidies to various population groups: all adults, teenagers, high-risk groups, and women of reproductive age. The impact of vaccines on the epidemic is compared with the impact of other prevention interventions such as condom use and behavior change. Finally, the models are used to explore the extent with which behavioral reversals may erode the positive benefits of the vaccine. A highly effective, long-lasting, inexpensive vaccine would be ideal and could make a major contribution in controlling the HIV/AIDS pandemic. But vaccines that do not attain this ideal can still be useful. A vaccine with 50 percent efficacy and 10 years duration supplied to 65 percent of all adults could reduce HIV incidence by 25 to 60 percent, depending on the context and stage of the epidemic. Better efficacy and longer duration would provide even more impact. Programs focused on teenagers or high-risk populations have less overall impact but would provide significant benefits at much less cost than those reaching all adults. Behavioral reversals could erode much of the benefits of vaccination programs so it will be important to combine vaccination with continued messages about the importance of safe behaviors. The cost of the vaccines is not known at this time. At a cost of $10 or $20 per person vaccinated, the cost per infection averted would be as low or lower than other prevention interventions. Higher costs for the vaccines and the need for many booster shots could reduce the cost-effectiveness significantly. 2013-08-06T16:10:58Z 2013-08-06T16:10:58Z 2002-03 http://documents.worldbank.org/curated/en/2002/03/1744002/epidemiological-impact-hivaids-vaccine-developing-countries http://hdl.handle.net/10986/14818 English en_US Policy Research Working Paper;No.2811 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, D.C. Publications & Research :: Policy Research Working Paper Publications & Research Africa East Asia and Pacific |