iClinic - July 24, 2000
Marjolein Harvey
But research done at the University of Cape Town, published in the Mail & guardian on Friday, argues the opposite. Jolene Scordess, an economist, has found that the ongoing treatment of infants infected with HIV could be between three and seven times higher than the cost of once-off treatment perinatally with AZT or Nevirapine, together with the provision of breast milk substitutes, to prevent mother-to-child transmission of HIV (MTCT).
"My study essentially offers a birds eye view of a lot of existing research that was out there," she told SABC radio on Monday.
"I pulled together 46 different scientific and clinical studies that were done around the world. I tried to put particular emphasis on studies that were done in developing countries or countries with similar profiles to SA.
"All I did was pull together numbers that were already out there. One of the reasons I have so much confidence in this study is that almost every number that is in it is backed up by more than one existing study." She shows that every HIV positive child over its short life could cost as much R19 000 for ongoing treatment, a figure of R1.7 billion over the life expectancy of these children.
"This is a hugely conservative estimate: it just includes the hospital room for the average number of days these children spend in hospital, and the cost of a welfare payment for these children," she says.
She says that realistically, medicinal costs for the treatment of opportunistic infections such as pneumonia should have been included, as well as the extra costs of taking care of these children, which often means a loss of income, extra costs of transport and funerals.
MTCT with AZT is just under R3 000 - this includes the drug, the HIV test, other clinical procedures and follow up as well as providing formula to mothers. With nevirapine the cost is less than R500.
She thinks one of the reasons government is so cautious may be lack of information.
"The studies that I waded through to pull this together are mostly very scientific in nature and they can be quite intimidating. But the information is largely not that accessible and very often conflicting," she says.
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