Our Approach to Economics and Costing

Data AnalyisAvenir Health performs a range of assessments using data for decisionmaking. This includes primary data collection and analysis, as well as secondary analysis of existing data, costing of national and decentralized health programs, analysis of markets and approximation of potential markets, and estimation of complex indicators. Results of the analyses are used by multinational organizations, international and national non-government organizations, donors, policy makers in developing countries, and individuals in a variety of public health fields.

Economics and Costing Projects

Costing HIV Prevention Interventions

Avenir Health has developed an online tool, the Unit Cost Repository, which contains detailed information on over 150 studies on HIV treatment and prevention interventions in developing countries. After incorporating comments on the final form of the data base received from numerous experts around the world, we designed an interactive web site that provides an easy-to-use interface to access the information in a variety of ways. The web-based data base includes quality scores for the individual studies, and also links to other databases in the field, where available. We also completed work on the studies underlying the effectiveness estimates used by the Goals model, including both an update of the studies that are included and a quality scoring which allows users to specify the acceptable number of limitations.

USAID Health Policy Initiative Costing Task Health Policy Plus (HP+)

Avenir Health contributes expertise in HIV costing and modeling to the USAID-funded Health Policy Plus (HP+). Team members support USG and host country governments in developing and using cost and modeling data for decision making, as well as training for counterparts on these topics. As part of the Costing TO, Avenir Health has modeled the impact of HIV treatment on prevention, completed cost and impact studies of male circumcision, PMTCT, and antiretroviral therapy, and analyzed resource allocation issues for HIV funding. The project also performed capacity building activities around costing and modeling in a number of countries and regions, including Lesotho, Mozambique, East Africa, South Asia, Southeast Asia, West Africa, Latin America and the Caribbean.


The Rush Foundation, in collaboration with the Copenhagen Consensus Center, commissioned a series of eighteen papers from teams of top health economists, epidemiologists, and demographers to answer the question, If we successfully raised an additional US$10 billion over the next 5 years to combat HIV/AIDS in sub-Saharan Africa, how could it best be spent? Avenir Health staff contributed three of these papers, including one of the six key analyses and two of the twelve perspective papers. A panel of five eminent economists, including three Nobel Prize winners, met in September 2011 to prioritize the suggested interventions, which included conversations with the authors. The reports are available online at www.rethinkhiv.com, and are also available in a volume published by Cambridge University Press.

Costs and Financing Working Group Costs and Financing Working Group

As part of the aids2031 Consortium, Avenir Health addressed key questions related to the costs and financing on resources needed for the HIV response through 2031 (50 years after the first AIDS case), including what are the long-term resource needs? What are the most important cost drivers? Are there ‘game-changers’ that could dramatically affect the price tag for fighting HIV? And what actions could be taken today to limit the growth of resources required? FI collaborated with several of the working groups (WG) to coordinate a coherent estimate, including the Science & Technology WG, the Social Drivers WG, the Programmatic Response WG, and the Steering Committee. In addition to the global analysis, Avenir Health also conducted national assessments in Cambodia and South Africa, focusing particularly on the required fiscal space needed to sustain and expand existing programs. Publications include journal articles and a book, available here.

Marie Stopes International Costing Calculator Marie Stopes International Costing Calculator

The Marie Stopes International (MSI) Costing Calculator was developed by Avenir Health to help MSI program managers and planners estimate the per client costs of family planning services. These costs are calculated and presented by means of delivery (i.e. clinic facility, outreach, mobile services etc.) and by type of family planning method.

The Global Epidemics of HIV among MSM The Global Epidemics of HIV among MSM in 2010: Epidemiology, Responses, and Human Rights

In collaboration with Johns Hopkins, FI estimated the impact of prevention interventions and providing ART targeting men who have sex with men (MSM) for Peru, Ukraine, Kenya and Thailand using the revised Goals model with four MSM categories (high-risk; medium-risk; low-risk; MSM-IDU). The countries were selected to represent different types of MSM epidemics: MSM are the predominant exposure group for HIV; same sex behavior is evaluated in the context of established HIV epidemics among IDU; same sex behavior is evaluated in the context of high prevalence and mature HIV epidemics among heterosexuals; and MSM, heterosexual, and IDU transmission all contribute significantly to the HIV epidemic). The initial results were presented at the Vienna Conference in July 2010, further results were to be presented at the 2011 Conference on Retroviruses and Opportunistic Infections, and there was a final publication in the International Journal of STD and AIDS.