Study Details

The Potential Impact of HIV/AIDS Interventions on the HIV/AIDS Epidemic in Africa: A Simulation Exercise for the World Bank


Bollinger L.  Stover J. 


March 2007



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Futures Institute


HIV/AIDS services, health systems strengthening, vulnerable groups, funding

Study Type

A background paper commissioned by the World Bank to inform its new Agenda for Action 2007-2011 HIV/AIDS strategy


The aim of the study is to determine areas where the Bank might maximise its comparative advantage.


This study combines quantitative (HIV/STI transmission modelling and qualitative analysis (the GOALS model - a tool that links program goals and funding) of previously published data to assess the impact of World Bank HIV/AIDS interventions.


The study compares three HIV/AIDS scenarios for prevention and treatment interventions by the World Bank that might assist it to calculate the number of lives saved, costs, and cost-effectiveness.

  • Base this assumes that the coverage levels of prevention and treatment interventions that existed in 2005 remain at the same level throughout the projection time period
  • Treatment this consists of increasing coverage from the current levels that are in the base scenario to reach universal access by 2010 (universal access is defined as covering 80% of adults and children in need of anti-retroviral therapy)
  • Prevention the treatment scenario plus various assumptions e.g., that prevention interventions are scaled-up in a linear fashion from the existing 2005 levels to coverage levels of 80-100 percent by 2010.
  • Base 300,000 people in need of treatment will receive it by 2011
  • Treatment scale up of treatment will result in 5m people entering ART programmes by 2011. By 2030, 2.5m deaths will have been averted per year and 14m life years gained. Scaling up access to ART to achieve universal access by 2011 will cost $3.2bn
  • Prevention scale up of prevention will result in a drop from 28m HIV positive people to 22m by 2011; new infections will drop by almost two thirds. Scaling up prevention to achieve universal access will cost $4.7bn by 2011.
  • Application of GOALS model found that the most cost-effective interventions are: funding for commercial sex workers, men who have sex with men, prevention of mother-to-child transmissions, and blood safety programmes.
  • Orphans and vulnerable children (OVCs) are in special need of assistance - by 2011, if all OVCs in need of support receive it, total resources required would be about US$3.3 billion.

Conclusions /

Three ways that the Bank could maximise its comparative advantage:

  • By funding fully the most cost effective interventions
  • By assisting in health systems strengthening to help scale-up of universal access to antiretroviral therapies
  • By funding OVC interventions


Further information can be obtained from Aisling Walsh or from Neil Spicer, or from any of the individual country researchers.

Last Updated: Friday 16th November 2007