The Potential Demand for and Strategic Use of an HIV-1 Vaccine in Southern India
No hay miniatura disponible
Fecha
Título de la revista
ISSN de la revista
Título del volumen
Editor
World Bank, Washington, DC
Resumen
Descripción
Even a modestly effective HIV-1 vaccine
would be highly useful in India and could avoid millions of
deaths. How should such a vaccine be introduced? Based on
evidence of adoption of other vaccines in India, current
levels of spending on them and coverage of prevention
programs targeting both high- and low-risk groups, Seshadri,
Subramaniyam, and Jha assess the potential demand for and
strategic use of an HIV-1 vaccine in the four southern
Indian states of Andhra Pradesh, Karnataka, Maharashtra, and
Tamil Nadu. The authors also discuss potential strategies
for delivery of the vaccine, prioritization for vaccination,
and the political economy of such a vaccine in India.
Assuming a vaccine cost of $10 a dose and including
estimated delivery costs, the total cost of vaccinating 21.6
million adolescents 11-14 years of age and 1 percent of
adults would be Rs. 12.25 billion (US$ 245 million). To
maintain the vaccination rate in the 11-14 year old cohort,
an additional 6.77 million in that age range would have to
be vaccinated each year, at a vaccine cost of Rs. 3.39
billion (US$ 67.5 million). An HIV-1 vaccine will greatly
reduce HIV/AIDS in India, but it will not be a panacea.
There will be a continued need for effective prevention
programs to guard against behavior reversals or an imperfect
vaccine. Key inputs for prevention, immunization, and
treatment programs such as identification of various groups
that could be immunized (vulnerable groups or general
populations), strengthened surveillance, capacity building,
operations research, and evaluation at local levels will
continue to require intensive support.
Palabras clave
HIV VIRUSES, VACCINES, VACCINATION, HEALTH ISSUES, HEALTH SERVICES, ACQUIRED IMMUNE DEFICIENCY SYNDROME VACCINES, PREVENTIVE MEDICINE, IMMUNIZATION, CAPACITY BUILDING, PUBLIC AWARENESS, PUBLIC HEALTH, FUNDING ACCESS TO EDUCATION, ADOLESCENT, ADOLESCENT GIRLS, ADOLESCENTS, ADULT POPULATION, ADULTHOOD, AGED, AGING, AIDS PREVENTION, AIDS VACCINE, ANTENATAL CARE, ANTENATAL CLINIC, ANTENATAL CLINICS, ASYMPTOMATIC INFECTIONS, AWARENESS CAMPAIGNS, BABIES, BEHAVIOR CHANGE, BEHAVIORAL SURVEILLANCE, BILATERAL DONORS, BIRTH RATE, BIRTHS, CHILD DEVELOPMENT, CHILD HEALTH, CHILDHOOD IMMUNIZATION, CLINICAL TRIALS, CLINICS, COMMERCIAL SEX, COMMERCIAL SEX WORKERS, CONDOM DISTRIBUTION, CONDOM PROMOTION, CONDOM USE, CONDOMS, CONTRACEPTION, DISCRIMINATION, DROPOUT RATES, DRUG USERS, EARLY DETECTION, EFFECTIVE PREVENTION, EFFECTIVE VACCINES, ENROLLMENT, ENROLLMENT RATES, EPIDEMIOLOGICAL FACTORS, FAMILIES, FAMILY HEALTH, FATIGUE, FEMALE SEX WORKERS, GIRLS, GOVERNMENT CLINICS, HEALTH CARE, HEALTH FACILITIES, HEALTH FACILITY, HEALTH INTERVENTIONS, HEPATITIS B, HEPATITIS B SURFACE ANTIGEN, HEPATITIS B VIRUS, HETEROSEXUAL TRANSMISSION, HIGH-RISK, HIGH-RISK GROUPS, HIGH-RISK POPULATIONS, HIV, HIV IMMUNIZATION, HIV INFECTIONS, HIV PREVENTION, HIV PREVENTION INTERVENTIONS, HIV VACCINATION, HOSPITALS, HUMAN IMMUNODEFICIENCY VIRUS, IMMUNIZATION, IMMUNIZATION COVERAGE, IMMUNODEFICIENCY, INFECTION, INFECTIONS, INFLUENZA, INHIBITION, INJECTING DRUG USERS, INSTITUTIONAL CAPACITY, INTERNATIONAL AIDS VACCINE INITIATIVE, INTERVENTION, LAWS, LEADERSHIP, LEARNING, LEARNING ACHIEVEMENT, MALE CLIENTS, MEASLES, MEDICAL RESEARCH, MOTHERS, NATIONAL AIDS CONTROL, NEONATAL TETANUS, NONGOVERNMENTAL ORGANIZATIONS, PARTNERSHIP, PATIENTS, POLIO, POLIO ERADICATION, PREGNANCY, PREGNANT WOMEN, PREVENTION EFFORTS, PREVENTION INTERVENTIONS, PREVENTIVE BEHAVIORS, PRIMARY HEALTH CARE, PRIMARY SCHOOL, PRIVATE SECTOR, PUBLIC HEALTH, PUBLIC SECTOR, PUBLIC SECTOR CLINICS, PUBLIC SERVICES, QUALITY ASSURANCE, REPRODUCTIVE AGE, RISK GROUPS, RISKY SEXUAL BEHAVIOR, RURAL AREAS, SCHOOLS, SEX WITH MEN, SEX WORKERS, SEXUALLY ACTIVE, SOCIAL MARKETING, SOCIAL SERVICES, STDS, STIS, SURVEILLANCE DATA, TARGET POPULATIONS, TECHNOLOGICAL ADVANCES, TETANUS, USE OF CONDOMS, VACCINATION, VACCINE PREVENTABLE DISEASES, VACCINES, VULNERABLE GROUPS, YOUTH, FUNDING, ACCESS TO EDUCATION