Economics of Tuberculosis Prevention and Treatment in South Africa

Project Description

South Africa bears a disproportionately large burden of HIV/tuberculosis (TB) co-infection and of multi-drug resistant tuberculosis (MDR-TB). Although the successful scaleup of antiretroviral therapy for HIV/AIDS has reduce HIV-related mortality, TB continues to be the largest single cause of adult death in the country, and MDR-TB accounts for a very large share of the national TB control budget. To help the Government of South Africa, PEPFAR, the WHO, and other organizations improve TB prevention, case-finding, diagnosis, and treatment, CGHD and its South African partner, the Health Economics and Epidemiology Research Office (HE2RO), launched a program of research on the economics of TB in 2010.

Research addresses two main areas:

• Site-level costs and outcomes of TB and MDR-TB treatment. At a number of clinics that delivery TB and/or MDR-TB treatment, CGHD and HE2RO are studying the outcomes of patients diagnosed with TB and the costs of providing TB treatment. Research is also underway to map the MDR-TB referral system within the City of Johannesburg, to help improve  the linkage of patients to care and treatment completion.

• Modeling the national costs of TB diagnosis and treatment. In 2011, the National Health Laboratory Service asked the CGHD/HE2RO team to help estimate the costs of introducing GeneXpert MTB/RIF (Cepheid) technology into public sector laboratories across the country, a policy announced by the Minister of Health earlier in the year. Cost models were developed for this purpose and are now being used to guide decisions about the pace of scaleup of Xpert capacity, the numbers and sizes of machines required, and the algorithms to be used to diagnose TB. The National TB Cost Model is also being expanded to incorporate up to date estimates of the costs of TB treatment, as well as diagnosis.

This project is one activity of the CGHD’s Economics and Epidemiology of HIV/AIDS Care and Treatment (South Africa Associate Award) and continues under the INROADS Award.

Project Details

Principal Investigator Sydney Rosen
Boston University Co-Investigators Gesine Meyer-Rath
Country(ies) South Africa
Dates of Research 2010 – 2017
  • USAID logo United States Agency for International Development (USAID)