Applying the 'no-one worse off' criterion to design Pareto efficient HIV responses in Sudan and Togo.

Stuart, RM; Haghparast-Bidgoli, H; Panovska-Griffiths, J; Grobicki, L; Skordis, J; Kerr, CC; Kedziora, DJ; Martin-Hughes, R; Kelly, SL; Wilson, DP

Applying the 'no-one worse off' criterion to design Pareto efficient HIV responses in Sudan and Togo.

Stuart, RM Haghparast-Bidgoli, H Panovska-Griffiths, J Grobicki, L Skordis, J Kerr, CC Kedziora, DJ Martin-Hughes, R Kelly, SL Wilson, DP

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Publisher:: Lippincott, Williams & Wilkins
Publication Type:: Journal Article
Citation:: AIDS, 2019, 33, (7), pp. 1247-1252
Issue Date:: 2019-06-01

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Field	Value	Language
dc.contributor.author	Stuart, RM
dc.contributor.author	Haghparast-Bidgoli, H
dc.contributor.author	Panovska-Griffiths, J
dc.contributor.author	Grobicki, L
dc.contributor.author	Skordis, J
dc.contributor.author	Kerr, CC
dc.contributor.author	Kedziora, DJ
dc.contributor.author	Martin-Hughes, R
dc.contributor.author	Kelly, SL
dc.contributor.author	Wilson, DP
dc.date.accessioned	2022-08-15T04:52:55Z
dc.date.available	2022-08-15T04:52:55Z
dc.date.issued	2019-06-01
dc.identifier.citation	AIDS, 2019, 33, (7), pp. 1247-1252
dc.identifier.issn	0269-9370
dc.identifier.issn	1473-5571
dc.identifier.uri	http://hdl.handle.net/10453/160203
dc.description.abstract	INTRODUCTION: Globally, there is increased focus on getting the greatest impact from available health funding. However, the pursuit of overall welfare maximization may mean some are left worse off than before. Pareto efficiency takes welfare shifts into account by ruling out funding reallocations that worsen outcomes for any person or group. METHODS: Using the Optima HIV model, studies of HIV response efficiency were conducted in Sudan in 2014 and Togo in 2015. In this article, we estimate the welfare maximizing and Pareto efficient allocations for these two national HIV budgets, using data from the original studies. RESULTS: We estimate that, if the 2013 HIV budget for Sudan was annually available to 2020 but with funds reallocated according to the welfare maximizing allocation, a 36% reduction in cumulative new infections could be achieved between 2014 and 2020. We also find that this is Pareto efficient. In Togo, however, we find that it is possible to reduce overall new infections but applying the Pareto efficiency criterion means that shifts in emphases cannot occur in the HIV response without additional resources. DISCUSSION: Protecting service coverage for key population groups is not necessarily equivalent to protecting health outcomes. In some cases, requiring Pareto efficiency may reduce the potential for population-wide welfare gains, but this is not always the case. CONCLUSION: Pareto efficiency may be an appropriate addition to the quantitative toolset for evaluating HIV responses.
dc.format	Print
dc.language	eng
dc.publisher	Lippincott, Williams & Wilkins
dc.relation.ispartof	AIDS
dc.relation.isbasedon	10.1097/QAD.0000000000002155
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	06 Biological Sciences, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Virology
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Age Distribution
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Budgets
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Female
dc.subject.mesh	Health Resources
dc.subject.mesh	HIV Infections
dc.subject.mesh	Humans
dc.subject.mesh	Infant
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Resource Allocation
dc.subject.mesh	Sex Distribution
dc.subject.mesh	Sudan
dc.subject.mesh	Togo
dc.subject.mesh	Young Adult
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Age Distribution
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Budgets
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Female
dc.subject.mesh	HIV Infections
dc.subject.mesh	Health Resources
dc.subject.mesh	Humans
dc.subject.mesh	Infant
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Resource Allocation
dc.subject.mesh	Sex Distribution
dc.subject.mesh	Sudan
dc.subject.mesh	Togo
dc.subject.mesh	Young Adult
dc.subject.mesh	Humans
dc.subject.mesh	HIV Infections
dc.subject.mesh	Age Distribution
dc.subject.mesh	Sex Distribution
dc.subject.mesh	Resource Allocation
dc.subject.mesh	Adolescent
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Aged, 80 and over
dc.subject.mesh	Middle Aged
dc.subject.mesh	Child
dc.subject.mesh	Child, Preschool
dc.subject.mesh	Infant
dc.subject.mesh	Infant, Newborn
dc.subject.mesh	Budgets
dc.subject.mesh	Health Resources
dc.subject.mesh	Sudan
dc.subject.mesh	Togo
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Young Adult
dc.title	Applying the 'no-one worse off' criterion to design Pareto efficient HIV responses in Sudan and Togo.
dc.type	Journal Article
utslib.citation.volume	33
utslib.location.activity	England
utslib.for	06 Biological Sciences
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Strength - AAI - Advanced Analytics Institute Research Centre
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-08-15T04:52:46Z
pubs.issue	7
pubs.publication-status	Published
pubs.volume	33
utslib.citation.issue	7

Abstract:

INTRODUCTION: Globally, there is increased focus on getting the greatest impact from available health funding. However, the pursuit of overall welfare maximization may mean some are left worse off than before. Pareto efficiency takes welfare shifts into account by ruling out funding reallocations that worsen outcomes for any person or group. METHODS: Using the Optima HIV model, studies of HIV response efficiency were conducted in Sudan in 2014 and Togo in 2015. In this article, we estimate the welfare maximizing and Pareto efficient allocations for these two national HIV budgets, using data from the original studies. RESULTS: We estimate that, if the 2013 HIV budget for Sudan was annually available to 2020 but with funds reallocated according to the welfare maximizing allocation, a 36% reduction in cumulative new infections could be achieved between 2014 and 2020. We also find that this is Pareto efficient. In Togo, however, we find that it is possible to reduce overall new infections but applying the Pareto efficiency criterion means that shifts in emphases cannot occur in the HIV response without additional resources. DISCUSSION: Protecting service coverage for key population groups is not necessarily equivalent to protecting health outcomes. In some cases, requiring Pareto efficiency may reduce the potential for population-wide welfare gains, but this is not always the case. CONCLUSION: Pareto efficiency may be an appropriate addition to the quantitative toolset for evaluating HIV responses.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/160203