CONTENTS
Chapters
- The Toll of STDs
- Reducing the Toll of STDs
- Managing STDs
- Diagnostic and Treatment Tips
- Getting Services to the People
- Getting People to Services
- Promoting Prevention—Condoms and Monogamy
HIGHLIGHTS
Population Reports is published by the Population Information Program, Center for Communication Programs, The
Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland
21202-4012, USA
Volume XXI, Number 1
June, 1993 |
Cost
The cost of STD programs is difficult to judge because only
a few programs have estimated costs. The national STD program in
Zambia, for example, costs an estimated US$1.3 million per year
(119). Managing STD patients at the district level costs about $7
per patient, including staff time, laboratory diagnosis,
treatment, and condoms (118).
Projections have been made based on studies or pilot STD
programs. For example:
- A program to prevent gonococcal ophthalmia neonatorum
in a typical country in East Africa with a population
of 20 million, one million births per year, and a 10%
prevalence of gonorrhea among pregnant women would cost
about US$65,000, or $.07 per infant treated, excluding
personnel costs. The program would prevent an estimated
47,000 cases at $1.38 per case prevented (271).
- Screening and treating 1.5 million pregnant women with a 10% prevalence of
syphilis in the same East African country would cost about US$900,000,
or $.60 per woman, excluding personnel costs. The program would prevent
75,000 spontaneous abortions, fetal or infant deaths, or cases of congenital
syphilis at a cost of $12 per sequela avoided (271) (see Chapter
6.2, Screening).
- In Mozambique managing about 39,000 STD patients and
their sexual partners, testing 50,000 pregnant women
for syphilis, and treating infected women would cost an
estimated US$427,000 a year, or $4.80 per person,
including personnel costs. This figure was estimated
from the cost of an STD pilot program in Maputo City
and province, an area with a population of one million
(21).
These estimates depend on the prevalence of STDs in the
population being served. Higher prevalence rates would increase
the total treatment costs but reduce the cost per sequela
avoided. By comparison, developing-country governments, donors,
and users spend an average of $10 to $14 per couple per year on
family planning supplies and services (160).
The extent of government and donor support for STD programs
varies from country to country. In some countries governments
provide most program funding, while in others donors provide
most. Donors include the United States Agency for International
Development (USAID), the Commission of the European Communities
(CEC) and many of its member countries, the World Bank, the
United Nations, and others. US AID has supported AIDS and STD
prevention activities in 70 developing countries, allocating over
US$158 million in bilateral assistance to these efforts between
1987 and 1991. AID plans to spend $400 million for programs
worldwide between 1991 and 1996 (302). The AIDS Control and
Prevention (AIDSCAP) Project managed by Family Health
International is the major AID-funded project implementing
programs in developing countries. The CEC contributed almost $90
million between 1986 and 1991 to AIDS/STD programs in developing
countries, not including funding for research. Member countries
contributed another $188 million in bilateral assistance between
1986 and 1991 (337). The World Bank supports more than 30
AIDS/STD projects (258). |