1. 25 July 2012 James G. Kahn, MD, MPH UCSF

2. Goal of analysis  Estimate the cost, health effects, and cost-effectiveness of a diarrhea, malaria and HIV IPC as implemented in Lurambi district, Western Kenya, September 2008.

3. Methods: Sources Program costs:  Empirical for campaign as implemented, plus modeled “Scaled-Up Replication” (SUR) Health effects (deaths and DALYs averted):  Published trials and meta-analyses, and disease incidence modeling Costs of medical care incurred/averted:  Published studies and databases

4. Results: Program Costs  As implemented: $42  SUR: $32

5. Results: Health Effects Diarrhea (Filters) Malaria (LLIN) HIV (VCT, condoms)TOTAL Deaths averted6.814.315.22 16.3 DALYs averted (prevention) 19112542 358.5 DALYs averted(earlier HIV care) -- 82 TOTAL DALYs 191125 441.8 Deaths and DALYs averted by intervention component:

6. Results: Costs Diarrhea (Filters) Malaria (LLIN) HIV (VCT, condoms)TOTAL Prevention $48,123$10,420$25,569 $85,113 Effect on use of ART -- ($37,097) Total $48,123$10,420($10,538) $48,015 Costs averted/(added) by intervention component:

7. Results: Cost-effectiveness

8. Conclusion  A mass, rapidly implemented IPC for HIV, malaria and diarrhea in a Western Kenya setting provides substantial health benefits in terms of deaths and DALYs averted  The campaign also appears economically attractive (cost-saving).