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Costing of National STI Program Implementation for the Global STI Control Strategy for the Health Sector, 2016-2021

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  • Eline L Korenromp
  • Teodora Wi
  • Stephen Resch
  • John Stover
  • Nathalie Broutet

Abstract

Introduction: In 2016 the World Health Assembly adopted the global strategy on Sexually Transmitted Infections (STI) 2016–2021 aiming to reduce curable STIs by 90% by 2030. We costed scaling-up priority interventions to coverage targets. Methods: Strategy-targeted declines in Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis were applied to WHO-estimated regional burdens at 2012. Syndromic case management was costed for these curable STIs, symptomatic Herpes Simplex Virus 2 (HSV-2), and non-STI vaginal syndromes, with incrementally expanding etiologic diagnosis. Service unit costs were multiplied with clinic attendances and people targeted for screening or prevention, by income tier. Human papilloma virus (HPV) vaccination and screening were costed for coverage increasing to 60% of 10-year-old girls for vaccination, and 60% of women 30–49 years for twice-lifetime screening (including clinical follow-up for positive screens), by 2021. Results: Strategy implementation will cost an estimated US$ 18.1 billion over 2016–2021 in 117 low- and middle-income countries. Cost drivers are HPV vaccination ($3.26 billion) and screening ($3.69 billion), adolescent chlamydia screening ($2.54 billion), and antenatal syphilis screening ($1.4 billion). Clinical management—of 18 million genital ulcers, 29–39 million urethral discharges and 42–53 million vaginal discharges annually—will cost $3.0 billion, including $818 million for service delivery and $1.4 billion for gonorrhea and chlamydia testing. Global costs increase from $2.6 billion to $ 4.0 billion over 2016–2021, driven by HPV services scale-up, despite vaccine price reduction. Sub-Saharan Africa, bearing 40% of curable STI burdens, covers 44% of global service needs and 30% of cost, the Western Pacific 15% of burden/need and 26% of cost, South-East Asia 20% of burden/need and 18% of cost. Conclusions: Costs of global STI control depend on price trends for HPV vaccines and chlamydia tests. Middle-income and especially low-income countries need increased investment, innovative financing, and synergizing with other health programs.

Suggested Citation

  • Eline L Korenromp & Teodora Wi & Stephen Resch & John Stover & Nathalie Broutet, 2017. "Costing of National STI Program Implementation for the Global STI Control Strategy for the Health Sector, 2016-2021," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-29, January.
  • Handle: RePEc:plo:pone00:0170773
    DOI: 10.1371/journal.pone.0170773
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    1. Nicole G Campos & Monisha Sharma & Andrew Clark & Jane J Kim & Stephen C Resch, 2016. "Resources Required for Cervical Cancer Prevention in Low- and Middle-Income Countries," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-20, October.
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    1. Cecilia Ferreyra & Jennifer Osborn & Francis Moussy & Emilie Alirol & Monica Lahra & David Whiley & William Shafer & Magnus Unemo & Jeffrey Klausner & Cassandra Kelly Cirino & Teodora Wi, 2020. "Developing target product profiles for Neisseria gonorrhoeae diagnostics in the context of antimicrobial resistance: An expert consensus," PLOS ONE, Public Library of Science, vol. 15(9), pages 1-15, September.
    2. Md. Nazmul Huda & Moin Uddin Ahmed & Md. Bakhtiar Uddin & Md Kamrul Hasan & Jalal Uddin & Tinashe Moira Dune, 2022. "Prevalence and Demographic, Socioeconomic, and Behavioral Risk Factors of Self-Reported Symptoms of Sexually Transmitted Infections (STIs) among Ever-Married Women: Evidence from Nationally Representa," IJERPH, MDPI, vol. 19(3), pages 1-15, February.

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