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Global burden of maternal and congenital syphilis and associated adverse birth outcomes—Estimates for 2016 and progress since 2012

, or the U.S. Centers for Disease Control and Prevention. Author Contributions M. Taylor. Newman. Conceptualization: Eline L. Korenromp, Jane Rowley, Lori Newman, Mary Kamb, Melanie Data curation ... : Eline L. Korenromp, Jane Rowley, Monica Alonso, Maeve B. Mello, Naoko Ishikawa, Linh-Vi Le, Morkor Newman-Owiredu, Melanie M. Taylor. Formal analysis: Eline L. Korenromp, Jane Rowley, Monica Alonso

The emerging health impact of voluntary medical male circumcision in Zimbabwe: An evaluation using three epidemiological models

helpful advice throughout the study. Author Contributions Conceptualization: John Stover, Timothy B. Hallett, Eline L. Korenromp. Formal analysis: Jessica B. McGillen, John Stover, Daniel J. Klein ... , Geraldine N. Chipendo, Isaac Taramusi, Eline L. Korenromp. Funding acquisition: John Stover. Investigation: Jessica B. McGillen, John Stover, Daniel J. Klein, Sinokuthemba Xaba, Geraldine N. Chipendo

Antiretroviral Treatment Scale-Up and Tuberculosis Mortality in High TB/HIV Burden Countries: An Econometric Analysis

Introduction Antiretroviral therapy (ART) reduces mortality in patients with active tuberculosis (TB), but the population-level relationship between ART coverage and TB mortality is untested. We estimated the reduction in population-level TB mortality that can be attributed to increasing ART coverage across 41 high HIV-TB burden countries. Methods We compiled TB mortality trends...

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

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...

The case for investing in the male condom

When used correctly and consistently, the male condom offers triple protection from unintended pregnancy and the transmission of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). However, with health funding levels stagnant or falling, it is important to understand the cost and health impact associated with prevention technologies. This study is one...

The prevalence and incidence of active syphilis in women in Morocco, 1995-2016: Model-based estimation and implications for STI surveillance

Background Evolving health priorities and resource constraints mean that countries require data on trends in sexually transmitted infections (STI) burden, to inform program planning and resource allocation. We applied the Spectrum STI estimation tool to estimate the prevalence and incidence of active syphilis in adult women in Morocco over 1995 to 2016. The results from the...

Impact and Cost of the HIV/AIDS National Strategic Plan for Mozambique, 2015-2019—Projections with the Spectrum/Goals Model

Introduction Mozambique continues to face a severe HIV epidemic and high cost for its control, largely born by international donors. We assessed feasible targets, likely impact and costs for the 2015–2019 national strategic HIV/AIDS plan (NSP). Methods The HIV epidemic and response was modelled in the Spectrum/Goals/Resource Needs dynamical simulation model, separately for North...

Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST), extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs) in the 1990s, confirm the substantial impact and good...

Methodological and Policy Limitations of Quantifying the Saving of Lives: A Case Study of the Global Fund's Approach

David McCoy and colleagues critique the dominance of “lives saved” models of assessing the impact of health programs, using The Global Fund as a case study. Please see later in the article for the Editors' Summary

Financing HIV Programming: How Much Should Low- And Middle-Income Countries and their Donors Pay?

Global HIV control funding falls short of need. To maximize health outcomes, it is critical that national governments sustain reasonable commitments, and that international donor assistance be distributed according to country needs and funding gaps. We develop a country classification framework in terms of actual versus expected national domestic funding, considering resource...

Health impact of external funding for HIV, tuberculosis and malaria: systematic review

Background Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis (TB) and malaria control. We undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts of these investments. Methods and findings We systematically searched databases for peer...

Progress towards malaria control targets in relation to national malaria programme funding

Background Malaria control has been dramatically scaled up the past decade, mainly thanks to increasing international donor financing since 2003. This study assessed progress up to 2010 towards global malaria impact targets, in relation to Global Fund, other donor and domestic malaria programme financing over 2003 to 2009. Methods Assessments used domestic malaria financing...

Outcomes and Impact of HIV Prevention, ART and TB Programs in Swaziland – Early Evidence from Public Health Triangulation

IntroductionSwaziland’s severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment (ART) program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling (HTC), tuberculosis (TB) and prevention of mother to...

Implementing the Global Plan to Stop TB, 2011–2015 – Optimizing Allocations and the Global Fund’s Contribution: A Scenario Projections Study

Background The Global Plan to Stop TB estimates funding required in low- and middle-income countries to achieve TB control targets set by the Stop TB Partnership within the context of the Millennium Development Goals. We estimate the contribution and impact of Global Fund investments under various scenarios of allocations across interventions and regions. Methodology/Principal...

Long-Term Costs and Health Impact of Continued Global Fund Support for Antiretroviral Therapy

Background By the end of 2011 Global Fund investments will be supporting 3.5 million people on antiretroviral therapy (ART) in 104 low- and middle-income countries. We estimated the cost and health impact of continuing treatment for these patients through 2020. Methods and Findings Survival on first-line and second-line ART regimens is estimated based on annual retention rates...

Clinical Prognostic Value of RNA Viral Load and CD4 Cell Counts during Untreated HIV-1 Infection—A Quantitative Review

Background The prognostic value of CD4 counts and RNA viral load for identifying treatment need in HIV-infected individuals depends on (a) variation within and among individuals, and (b) relative risks of clinical progression per unit CD4 or RNA difference. Methodology/Principal Findings We reviewed these measurements across (a) 30 studies, and (b) 16 cohorts of untreated...

PEDIATRIC MORTALITY IN AFRICA: PLASMODIUM FALCIPARUM MALARIA AS A CAUSE OR RISK?

ROBERT W. SNOW 0 ELINE L. KORENROMP 0 ELEANOR GOUWS 0 0 Kenya Medical Research Institute-Wellcome Trust Collaborative Program, Nairobi, Kenya; Centre for Tropical Medicine, University of Oxford, John ... Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom, Telephone: 254-2-272-0163, E-mail: rsnow@wtnairobi.mimcom. net. Eline L. Korenromp Malaria Control Department, World Health Organization

HIV Infection, Antiretroviral Therapy, and CD4+ Cell Count Distributions in African Populations

BackgroundThe variability in CD4+ cell counts within and among human immunodeficiency virus (HIV)–positive and –negative African populations has not been explained but has important implications for understanding the incidence of HIV-related opportunistic infections, especially tuberculosis, in both individuals and populations MethodsIn HIV-negative African adults, CD4+ cell...

Estimating the Resources Needed and Savings Anticipated from Roll-Out of Adult Male Circumcision in Sub-Saharan Africa

Background Trials in Africa indicate that medical adult male circumcision (MAMC) reduces the risk of HIV by 60%. MAMC may avert 2 to 8 million HIV infections over 20 years in sub-Saharan Africa and cost less than treating those who would have been infected. This paper estimates the financial and human resources required to roll out MAMC and the net savings due to reduced...