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Costing of National STI Program Implementation, 2016-2021

2017

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. This analysis costed scaling-up priority interventions to achieve coverage targets.

Strategy-targeted declines in Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Trichomonas vaginalis were applied to WHO-estimated regional burdens at 2012 levels. Case management was costed for the curable STIs, symptomatic Herpes Simplex Virus 2 (HSV-2), and non-STI vaginal syndromes, with incrementally expanding diagnoses. Service unit costs were multiplied by clinic attendances and people targeted for screening or prevention, by income tier. 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 by 2021.

The authors estimate that implementation will cost an estimated US$ 18.1 billion over the 2016–2021 period 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 genital ulcers, urethral discharges and 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.

 

Source:

Korenromp EL, Wi Theodora, Resch S et al. Costing of National STI Program Implementation for the Global STI Control Strategy for the Health Sector, 2016-2021. PLOS One 2017: 12; 1: e0170773. https://doi.org/10.1371/journal.pone.0170773