Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia

Cases of human immunodeficiency virus (HIV) infections were first detected in Malaysia in 1986. Since then, the number of new HIV cases has been increasing steadily to a peak of 6,978 new cases detected in 2002 then declining to 3,438 new cases in...

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Main Authors: Naning, Herlianna, Kerr, Cliff, Kamarulzaman, Adeeba, Osornprasop, Sutayut, Dahlui, Maznah, Ng, Chiu-Wan, Wilson, David P.
Format: Working Paper
Language:English
en_US
Published: Washington, DC 2014
Subjects:
AID
ARI
GPS
HIV
SEX
TB
Online Access:http://documents.worldbank.org/curated/en/2014/01/19533085/return-investment-cost-effectiveness-harm-reduction-program-malaysia
http://hdl.handle.net/10986/18641
id okr-10986-18641
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 ACQUIRED IMMUNE DEFICIENCY SYNDROME
ACQUIRED IMMUNODEFICIENCY SYNDROME
ADDICTION
AID
AMPHETAMINES
ARI
BLOOD TRANSFUSION
CANCERS
CAUSES OF DEATH
CERVICAL CANCER
CHILDHOOD
CIRCUMCISION
CITIZENS
CLINICAL PROTOCOLS
CLINICS
CONDOMS
COST EFFECTIVENESS
CRIME
CURRENT POPULATION
DEATH RATE
DEATH RATES
DEATHS
DECISION MAKING
DEPENDANTS
DEVELOPING COUNTRIES
DIAGNOSES
DISABILITY
DISEASE
DISEASE BURDEN
DISEASE CONTROL
DISEASE TRANSMISSION
DRUG ADDICTION
DRUG USERS
DRUGS
EPIDEMIC
EPIDEMIOLOGY
EXPENDITURES
FEMALE
GENDER
GENERAL PRACTITIONER
GENERIC DRUGS
GLOBAL CONSENSUS
GOVERNMENT AGENCIES
GPS
GROSS DOMESTIC PRODUCT
HARM REDUCTION
HEALTH CARE
HEALTH CARE COSTS
HEALTH CARE FACILITIES
HEALTH CARE RESEARCH
HEALTH CARE SERVICES
HEALTH COSTS
HEALTH FACILITIES
HEALTH SECTOR
HEALTH SERVICES
HEALTH STRATEGY
HEPATITIS
HEPATITIS C
HIV
HIV INFECTION
HIV INFECTIONS
HIV POSITIVE
HIV PREVENTION
HIV TESTING
HIV TRANSMISSION
HIV/AIDS
HOSPITAL
HOSPITALS
HUMAN IMMUNODEFICIENCY VIRUS
HUMAN RESOURCES
HYGIENE
ILLNESS
IMMUNE DEFICIENCY
IMMUNODEFICIENCY
IMPORTANT POLICY
INCOME
INFECTION RATE
INFECTIOUS DISEASES
INFORMATION SYSTEM
INPATIENT CARE
INTEGRATION
INTERVENTION
INTRAVENOUS DRUG USE
ISOLATION
JOB OPPORTUNITIES
MALARIA
MALES
MEDICAL PRACTITIONERS
METHADONE
MINISTRY OF HEALTH
MORBIDITY
MORTALITY
MOTHER
MOTHER TO CHILD
MOVEMENT OF PEOPLE
NATIONAL AIDS
NATIONAL DRUG
NATIONAL LEVEL
NATIONAL POLICY
NUMBER OF NEW INFECTIONS
NUMBER OF PEOPLE
OPPORTUNISTIC INFECTIONS
OUTPATIENT CARE
OUTPATIENT SERVICES
PAP SMEAR
PATIENT
PATIENTS
POLICY DISCUSSIONS
POPULATION DATA
POPULATION SIZE
PREVALENCE
PREVENTION ACTIVITIES
PRISONS
PROBABILITY
PROGRESS
PUBLIC DEMAND
PUBLIC HEALTH
PUBLIC HEALTH CARE
PUBLIC HEALTH SERVICES
PUBLIC SERVICES
PUBLIC SUPPORT
QUALITY OF LIFE
QUALITY OF SERVICES
REHABILITATION
REHABILITATION CENTRES
RESOURCE ALLOCATIONS
RESOURCE NEEDS
RESPECT
SCREENING
SERVICE PROVIDERS
SEX
SEX WITH MEN
SEX WORKERS
SOCIAL CONSEQUENCES
SPECIALIST
SYMPTOMS
SYRINGES
TB
TECHNICAL ASSISTANCE
THERAPIES
THERAPY
TREATMENT
USER FEES
VACCINATION
VIRUS INFECTIONS
VOLUNTARY COUNSELLING
spellingShingle ACQUIRED IMMUNE DEFICIENCY SYNDROME
ACQUIRED IMMUNODEFICIENCY SYNDROME
ADDICTION
AID
AMPHETAMINES
ARI
BLOOD TRANSFUSION
CANCERS
CAUSES OF DEATH
CERVICAL CANCER
CHILDHOOD
CIRCUMCISION
CITIZENS
CLINICAL PROTOCOLS
CLINICS
CONDOMS
COST EFFECTIVENESS
CRIME
CURRENT POPULATION
DEATH RATE
DEATH RATES
DEATHS
DECISION MAKING
DEPENDANTS
DEVELOPING COUNTRIES
DIAGNOSES
DISABILITY
DISEASE
DISEASE BURDEN
DISEASE CONTROL
DISEASE TRANSMISSION
DRUG ADDICTION
DRUG USERS
DRUGS
EPIDEMIC
EPIDEMIOLOGY
EXPENDITURES
FEMALE
GENDER
GENERAL PRACTITIONER
GENERIC DRUGS
GLOBAL CONSENSUS
GOVERNMENT AGENCIES
GPS
GROSS DOMESTIC PRODUCT
HARM REDUCTION
HEALTH CARE
HEALTH CARE COSTS
HEALTH CARE FACILITIES
HEALTH CARE RESEARCH
HEALTH CARE SERVICES
HEALTH COSTS
HEALTH FACILITIES
HEALTH SECTOR
HEALTH SERVICES
HEALTH STRATEGY
HEPATITIS
HEPATITIS C
HIV
HIV INFECTION
HIV INFECTIONS
HIV POSITIVE
HIV PREVENTION
HIV TESTING
HIV TRANSMISSION
HIV/AIDS
HOSPITAL
HOSPITALS
HUMAN IMMUNODEFICIENCY VIRUS
HUMAN RESOURCES
HYGIENE
ILLNESS
IMMUNE DEFICIENCY
IMMUNODEFICIENCY
IMPORTANT POLICY
INCOME
INFECTION RATE
INFECTIOUS DISEASES
INFORMATION SYSTEM
INPATIENT CARE
INTEGRATION
INTERVENTION
INTRAVENOUS DRUG USE
ISOLATION
JOB OPPORTUNITIES
MALARIA
MALES
MEDICAL PRACTITIONERS
METHADONE
MINISTRY OF HEALTH
MORBIDITY
MORTALITY
MOTHER
MOTHER TO CHILD
MOVEMENT OF PEOPLE
NATIONAL AIDS
NATIONAL DRUG
NATIONAL LEVEL
NATIONAL POLICY
NUMBER OF NEW INFECTIONS
NUMBER OF PEOPLE
OPPORTUNISTIC INFECTIONS
OUTPATIENT CARE
OUTPATIENT SERVICES
PAP SMEAR
PATIENT
PATIENTS
POLICY DISCUSSIONS
POPULATION DATA
POPULATION SIZE
PREVALENCE
PREVENTION ACTIVITIES
PRISONS
PROBABILITY
PROGRESS
PUBLIC DEMAND
PUBLIC HEALTH
PUBLIC HEALTH CARE
PUBLIC HEALTH SERVICES
PUBLIC SERVICES
PUBLIC SUPPORT
QUALITY OF LIFE
QUALITY OF SERVICES
REHABILITATION
REHABILITATION CENTRES
RESOURCE ALLOCATIONS
RESOURCE NEEDS
RESPECT
SCREENING
SERVICE PROVIDERS
SEX
SEX WITH MEN
SEX WORKERS
SOCIAL CONSEQUENCES
SPECIALIST
SYMPTOMS
SYRINGES
TB
TECHNICAL ASSISTANCE
THERAPIES
THERAPY
TREATMENT
USER FEES
VACCINATION
VIRUS INFECTIONS
VOLUNTARY COUNSELLING
Naning, Herlianna
Kerr, Cliff
Kamarulzaman, Adeeba
Osornprasop, Sutayut
Dahlui, Maznah
Ng, Chiu-Wan
Wilson, David P.
Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia
geographic_facet East Asia and Pacific
Malaysia
description Cases of human immunodeficiency virus (HIV) infections were first detected in Malaysia in 1986. Since then, the number of new HIV cases has been increasing steadily to a peak of 6,978 new cases detected in 2002 then declining to 3,438 new cases in 2012. In response to the escalating epidemic, the Government of Malaysia (GOM) agreed the implementation of needle syringe program (NSP) and methadone maintenance therapy (MMT) programs against much public opposition which viewed these programs as being against the Islamic religion and will encourage more people to use drugs. The main objectives of this study are to evaluate whether the harm reduction program in Malaysia is cost-effective and also whether they provide return on investments (ROIs) to the government. The study used an epidemiologic mathematical model of HIV transmission and disease progression, called the projection and evaluation tool (Prevtool) developed by a team of investigators at the Kirby Institute, University of New South Wales, Australia to simulate the impact of MMT and NSP on the transmission of HIV among people who inject drugs (PWIDs) in Malaysia. Briefly, the model simulates the number of PWID who become infected with HIV over time as well as the extent of disease progression among those infected in the presence and absence of harm reduction program in the country. This study has shown that the combined MMT and NSP programs as implemented in Malaysia are cost-effective and are expected to produce net cost-savings to the government in the future. Evidence of cost-effectiveness and expected cost-savings support policy recommendation that both MMT and NSP programs should be maintained as part of the key strategy to control HIV spread among PWIDs in Malaysia. Study findings that even with the present program coverage, harm reduction activities are expected to become more cost-effective and cost-saving in the future suggest that policies towards program expansion may demonstrate higher value for money.
format Publications & Research :: Working Paper
author Naning, Herlianna
Kerr, Cliff
Kamarulzaman, Adeeba
Osornprasop, Sutayut
Dahlui, Maznah
Ng, Chiu-Wan
Wilson, David P.
author_facet Naning, Herlianna
Kerr, Cliff
Kamarulzaman, Adeeba
Osornprasop, Sutayut
Dahlui, Maznah
Ng, Chiu-Wan
Wilson, David P.
author_sort Naning, Herlianna
title Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia
title_short Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia
title_full Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia
title_fullStr Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia
title_full_unstemmed Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia
title_sort return on investment and cost-effectiveness of harm reduction program in malaysia
publisher Washington, DC
publishDate 2014
url http://documents.worldbank.org/curated/en/2014/01/19533085/return-investment-cost-effectiveness-harm-reduction-program-malaysia
http://hdl.handle.net/10986/18641
_version_ 1764442437510496256
spelling okr-10986-186412021-04-23T14:03:48Z Return on Investment and Cost-Effectiveness of Harm Reduction Program in Malaysia Naning, Herlianna Kerr, Cliff Kamarulzaman, Adeeba Osornprasop, Sutayut Dahlui, Maznah Ng, Chiu-Wan Wilson, David P. ACQUIRED IMMUNE DEFICIENCY SYNDROME ACQUIRED IMMUNODEFICIENCY SYNDROME ADDICTION AID AMPHETAMINES ARI BLOOD TRANSFUSION CANCERS CAUSES OF DEATH CERVICAL CANCER CHILDHOOD CIRCUMCISION CITIZENS CLINICAL PROTOCOLS CLINICS CONDOMS COST EFFECTIVENESS CRIME CURRENT POPULATION DEATH RATE DEATH RATES DEATHS DECISION MAKING DEPENDANTS DEVELOPING COUNTRIES DIAGNOSES DISABILITY DISEASE DISEASE BURDEN DISEASE CONTROL DISEASE TRANSMISSION DRUG ADDICTION DRUG USERS DRUGS EPIDEMIC EPIDEMIOLOGY EXPENDITURES FEMALE GENDER GENERAL PRACTITIONER GENERIC DRUGS GLOBAL CONSENSUS GOVERNMENT AGENCIES GPS GROSS DOMESTIC PRODUCT HARM REDUCTION HEALTH CARE HEALTH CARE COSTS HEALTH CARE FACILITIES HEALTH CARE RESEARCH HEALTH CARE SERVICES HEALTH COSTS HEALTH FACILITIES HEALTH SECTOR HEALTH SERVICES HEALTH STRATEGY HEPATITIS HEPATITIS C HIV HIV INFECTION HIV INFECTIONS HIV POSITIVE HIV PREVENTION HIV TESTING HIV TRANSMISSION HIV/AIDS HOSPITAL HOSPITALS HUMAN IMMUNODEFICIENCY VIRUS HUMAN RESOURCES HYGIENE ILLNESS IMMUNE DEFICIENCY IMMUNODEFICIENCY IMPORTANT POLICY INCOME INFECTION RATE INFECTIOUS DISEASES INFORMATION SYSTEM INPATIENT CARE INTEGRATION INTERVENTION INTRAVENOUS DRUG USE ISOLATION JOB OPPORTUNITIES MALARIA MALES MEDICAL PRACTITIONERS METHADONE MINISTRY OF HEALTH MORBIDITY MORTALITY MOTHER MOTHER TO CHILD MOVEMENT OF PEOPLE NATIONAL AIDS NATIONAL DRUG NATIONAL LEVEL NATIONAL POLICY NUMBER OF NEW INFECTIONS NUMBER OF PEOPLE OPPORTUNISTIC INFECTIONS OUTPATIENT CARE OUTPATIENT SERVICES PAP SMEAR PATIENT PATIENTS POLICY DISCUSSIONS POPULATION DATA POPULATION SIZE PREVALENCE PREVENTION ACTIVITIES PRISONS PROBABILITY PROGRESS PUBLIC DEMAND PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH SERVICES PUBLIC SERVICES PUBLIC SUPPORT QUALITY OF LIFE QUALITY OF SERVICES REHABILITATION REHABILITATION CENTRES RESOURCE ALLOCATIONS RESOURCE NEEDS RESPECT SCREENING SERVICE PROVIDERS SEX SEX WITH MEN SEX WORKERS SOCIAL CONSEQUENCES SPECIALIST SYMPTOMS SYRINGES TB TECHNICAL ASSISTANCE THERAPIES THERAPY TREATMENT USER FEES VACCINATION VIRUS INFECTIONS VOLUNTARY COUNSELLING Cases of human immunodeficiency virus (HIV) infections were first detected in Malaysia in 1986. Since then, the number of new HIV cases has been increasing steadily to a peak of 6,978 new cases detected in 2002 then declining to 3,438 new cases in 2012. In response to the escalating epidemic, the Government of Malaysia (GOM) agreed the implementation of needle syringe program (NSP) and methadone maintenance therapy (MMT) programs against much public opposition which viewed these programs as being against the Islamic religion and will encourage more people to use drugs. The main objectives of this study are to evaluate whether the harm reduction program in Malaysia is cost-effective and also whether they provide return on investments (ROIs) to the government. The study used an epidemiologic mathematical model of HIV transmission and disease progression, called the projection and evaluation tool (Prevtool) developed by a team of investigators at the Kirby Institute, University of New South Wales, Australia to simulate the impact of MMT and NSP on the transmission of HIV among people who inject drugs (PWIDs) in Malaysia. Briefly, the model simulates the number of PWID who become infected with HIV over time as well as the extent of disease progression among those infected in the presence and absence of harm reduction program in the country. This study has shown that the combined MMT and NSP programs as implemented in Malaysia are cost-effective and are expected to produce net cost-savings to the government in the future. Evidence of cost-effectiveness and expected cost-savings support policy recommendation that both MMT and NSP programs should be maintained as part of the key strategy to control HIV spread among PWIDs in Malaysia. Study findings that even with the present program coverage, harm reduction activities are expected to become more cost-effective and cost-saving in the future suggest that policies towards program expansion may demonstrate higher value for money. 2014-06-12T19:00:28Z 2014-06-12T19:00:28Z 2014-01 http://documents.worldbank.org/curated/en/2014/01/19533085/return-investment-cost-effectiveness-harm-reduction-program-malaysia http://hdl.handle.net/10986/18641 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ Washington, DC Publications & Research :: Working Paper Publications & Research East Asia and Pacific Malaysia