Global Evidence of Comparative Efficiency: Performance of National HIV/AIDS Programs Donald S. Shepard, PhD Wu Zeng, MD, PhD Jon Chilingerian, PhD Carlos Avila-Figueroa, MD, ScD Presented to the Global Fund for AIDS, Tuberculosis, and Malaria Geneva, Switzerland April 13, 2011 Schneider Institutes for Health Policy, Heller School Brandeis University, Waltham, MA USA Supported by UNAIDS

Outline Background Component I: Performance of national HIV/AIDS programs Component II: Determinants of efficiency of national HIV/AIDS programs Conclusions and limitations 2

3 Framework Input(s) Output(s) Production unit (e.g. national AIDS program)

Component I: Performance of national HIV/AIDS programs Objective: To evaluate the efficiency of national HIV/AIDS programs Methods: Data envelopment analysis (DEA) –Input: Total national spending on HIV/AIDS –Outputs: 1.Number of people receiving voluntary counseling and testing (VCT) 2.Number of HIV+ pregnant women receiving HIV/AIDS treatment for prevention from mother to children transmission (PMTCT) 3.Number of AIDS patients receiving ARV treatment (ART) 4

5 Input(s) Output(s) Production unit (e.g. national AIDS program)

Data sources: country-years by variable (Total: 151 country years, covering 68 countries, ) 6

Verification of imputation 7