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Economic Support to Patients in HIV and TB Grants in Rounds 7 and 10 from the Global Fund to Fight AIDS, Tuberculosis and Malaria

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  • Linda M Richter
  • Knut Lönnroth
  • Chris Desmond
  • Robin Jackson
  • Ernesto Jaramillo
  • Diana Weil

Abstract

People with TB and/or HIV frequently experience severe economic barriers to health care, including out-of-pocket expenses related to diagnosis and treatment, as well as indirect costs due to loss of income. These barriers can both aggravate economic hardship and prevent or delay diagnosis, treatment and successful outcome, leading to increased transmission, morbidity and mortality. WHO, UNAIDS and the ILO argue that economic support of various kinds is essential to enable vulnerable people to protect themselves from infection, avoid delayed diagnosis and treatment, overcome barriers to adherence, and avert destitution. This paper analyses successful country proposals to the Global Fund to Fight AIDS, Tuberculosis and Malaria that include economic support in Rounds 7 and 10; 36 and 20 HIV and TB grants in Round 7 and 32 and 26, respectively, in Round 10. Of these, up to 84 percent included direct or indirect economic support for beneficiaries, although the amount constituted a very small proportion of the total grant. In TB grants, the objectives of economic support were generally clearly stated, and focused on mechanisms to improve treatment uptake and adherence, and the case was most clearly made for MDR-TB patients. In HIV grants, the objectives were much broader in scope, including mitigation of adverse economic and social effects of HIV and its treatment on both patients and families. The analysis shows that economic support is on the radar for countries developing Global Fund proposals, and a wide range of economic support activities are in place. In order to move forward in this area, the wealth of country experience that exists needs to be collated, assessed and disseminated. In addition to trials, operational research and programme evaluations, more precise guidance to countries is needed to inform evidence-based decision about activities that are cost-effective, affordable and feasible.

Suggested Citation

  • Linda M Richter & Knut Lönnroth & Chris Desmond & Robin Jackson & Ernesto Jaramillo & Diana Weil, 2014. "Economic Support to Patients in HIV and TB Grants in Rounds 7 and 10 from the Global Fund to Fight AIDS, Tuberculosis and Malaria," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-9, January.
    • Handle: RePEc:plo:pone00:0086225
    DOI: 10.1371/journal.pone.0086225
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    References listed on IDEAS

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    1. Lönnroth, Knut & Jaramillo, Ernesto & Williams, Brian G. & Dye, Christopher & Raviglione, Mario, 2009. "Drivers of tuberculosis epidemics: The role of risk factors and social determinants," Social Science & Medicine, Elsevier, vol. 68(12), pages 2240-2246, June.
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    3. Salla A Munro, 2007. "Patient Adherence to Tuberculosis Treatment: A Systematic Review of Qualitative Research," Working Papers id:1107, eSocialSciences.
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    1. Rosa van Hoorn & Ernesto Jaramillo & David Collins & Agnes Gebhard & Susan van den Hof, 2016. "The Effects of Psycho-Emotional and Socio-Economic Support for Tuberculosis Patients on Treatment Adherence and Treatment Outcomes – A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-27, April.
    2. Fukushi Morishita & Rajendra-Prasad Yadav & Mao Tan Eang & Saly Saint & Nobuyuki Nishikiori, 2016. "Mitigating Financial Burden of Tuberculosis through Active Case Finding Targeting Household and Neighbourhood Contacts in Cambodia," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-22, September.
    3. Hubert Barennes & Amphonexay Frichittavong & Marissa Gripenberg & Paulin Koffi, 2015. "Evidence of High Out of Pocket Spending for HIV Care Leading to Catastrophic Expenditure for Affected Patients in Lao People's Democratic Republic," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-20, September.
    4. Andrew G Flynn & Godwin Anguzu & Frank Mubiru & Agnes N Kiragga & Moses Kamya & David B Meya & David R Boulware & Andrew Kambugu & Barbara C Castelnuovo, 2017. "Socioeconomic position and ten-year survival and virologic outcomes in a Ugandan HIV cohort receiving antiretroviral therapy," PLOS ONE, Public Library of Science, vol. 12(12), pages 1-12, December.

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