1. 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 02454-9110 USA Supported by UNAIDS

2. 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. 3 Framework Input(s) Output(s) Production unit (e.g. national AIDS program)

4. 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. 5 Input(s) Output(s) Production unit (e.g. national AIDS program)

6. Data sources: country-years by variable (Total: 151 country years, covering 68 countries, 2002-2007) 6

7. Verification of imputation 7