IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0002679.html
   My bibliography  Save this article

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

Author

Listed:
  • Bertran Auvert
  • Elliot Marseille
  • Eline L Korenromp
  • James Lloyd-Smith
  • Remi Sitta
  • Dirk Taljaard
  • Carel Pretorius
  • Brian Williams
  • James G Kahn

Abstract

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 infections. Methods: We developed a model which included costing, demography and HIV epidemiology. We used it to investigate 14 countries in sub-Saharan Africa where the prevalence of male circumcision was lower than 80% and HIV prevalence among adults was higher than 5%, in addition to Uganda and the Nyanza province in Kenya. We assumed that the roll-out would take 5 years and lead to an MC prevalence among adult males of 85%. We also assumed that surgery would be done as it was in the trials. We calculated public program cost, number of full-time circumcisers and net costs or savings when adjusting for averted HIV treatments. Costs were in USD, discounted to 2007. 95% percentile intervals (95% PI) were estimated by Monte Carlo simulations. Results: In the first 5 years the number of circumcisers needed was 2 282 (95% PI: 2 018 to 2 959), or 0.24 (95% PI: 0.21 to 0.31) per 10 000 adults. In years 6–10, the number of circumcisers needed fell to 513 (95% PI: 452 to 664). The estimated 5-year cost of rolling out MAMC in the public sector was $919 million (95% PI: 726 to 1 245). The cumulative net cost over the first 10 years was $672 million (95% PI: 437 to 1 021) and over 20 years there were net savings of $2.3 billion (95% PI: 1.4 to 3.4). Conclusion: A rapid roll-out of MAMC in sub-Saharan Africa requires substantial funding and a high number of circumcisers for the first five years. These investments are justified by MAMC's substantial health benefits and the savings accrued by averting future HIV infections. Lower ongoing costs and continued care savings suggest long-term sustainability.

Suggested Citation

  • Bertran Auvert & Elliot Marseille & Eline L Korenromp & James Lloyd-Smith & Remi Sitta & Dirk Taljaard & Carel Pretorius & Brian Williams & James G Kahn, 2008. "Estimating the Resources Needed and Savings Anticipated from Roll-Out of Adult Male Circumcision in Sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 3(8), pages 1-8, August.
    • Handle: RePEc:plo:pone00:0002679
    DOI: 10.1371/journal.pone.0002679
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0002679
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0002679&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0002679?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. World Bank, 2008. "Africa Development Indicators 2007," World Bank Publications - Books, The World Bank Group, number 12363, December.
    2. World Bank, 2008. "World Development Indicators 2008," World Bank Publications - Books, The World Bank Group, number 11855, December.
    3. repec:wbk:wbpubs:12362 is not listed on IDEAS
    4. World Bank, 2007. "World Development Indicators 2007," World Bank Publications - Books, The World Bank Group, number 8150, December.
    5. James G Kahn & Elliot Marseille & Bertran Auvert, 2006. "Cost-Effectiveness of Male Circumcision for HIV Prevention in a South African Setting," PLOS Medicine, Public Library of Science, vol. 3(12), pages 1-10, December.
    6. World Bank, 2008. "World Development Indicators 2008," World Bank Publications - Books, The World Bank Group, number 28241, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Djesika D Amendah & George Mukamah & Albert Komba & Carolyne Ndila & Thomas N Williams, 2013. "Routine Paediatric Sickle Cell Disease (SCD) Outpatient Care in a Rural Kenyan Hospital: Utilization and Costs," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-6, April.
    2. Olalekan A Uthman & Taiwo Aderemi Popoola & Mubashir M B Uthman & Olatunde Aremu, 2010. "Economic Evaluations of Adult Male Circumcision for Prevention of Heterosexual Acquisition of HIV in Men in Sub-Saharan Africa: A Systematic Review," PLOS ONE, Public Library of Science, vol. 5(3), pages 1-7, March.
    3. Veena Menon & Elizabeth Gold & Ramona Godbole & Delivette Castor & Hally Mahler & Steven Forsythe & Mariam Ally & Emmanuel Njeuhmeli, 2014. "Costs and Impacts of Scaling up Voluntary Medical Male Circumcision in Tanzania," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-8, May.
    4. Rosa Macipe-Costa & Nuria García-Sanchez & Luis Gimeno-Feliu & Beatriz Navarra-Vicente & Juan Jiménez-Hereza & Isabel Moneo-Hernández & Jose Castillo-Laita & Pilar Lobera-Navaz, 2014. "Non-therapeutic male circumcision performed on immigrant children from Africa in Spain," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(2), pages 351-358, April.
    5. Bruce Larson & Allan Tindikahwa & George Mwidu & Hannah Kibuuka & Fred Magala, 2015. "How Much Does It Cost to Improve Access to Voluntary Medical Male Circumcision among High-Risk, Low-Income Communities in Uganda?," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-11, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Andersen, Thomas Barnebeck & Dalgaard, Carl-Johan, 2013. "Power outages and economic growth in Africa," Energy Economics, Elsevier, vol. 38(C), pages 19-23.
    2. Yu, Bingxin & You, Liangzhi & Fan, Shenggen, 2010. "Toward a typology of food security in developing countries:," IFPRI discussion papers 945, International Food Policy Research Institute (IFPRI).
    3. Pamuk, H., 2014. "Innovation systems, saving, trust, and economic development in Africa," Other publications TiSEM c759f3ee-97a6-4689-a0d7-b, Tilburg University, School of Economics and Management.
    4. James, Jennifer S. & Pardey, Philip G. & Alston, Julian M., 2008. "Agricultural R&D Policy: A Tragedy of the International Commons," Staff Papers 43094, University of Minnesota, Department of Applied Economics.
    5. Bryan K. Ritchie, 2010. "Systemic Vulnerability and Sustainable Economic Growth," Books, Edward Elgar Publishing, number 13731.
    6. Niklas Potrafke, 2012. "Political cycles and economic performance in OECD countries: empirical evidence from 1951–2006," Public Choice, Springer, vol. 150(1), pages 155-179, January.
    7. Christian Bjørnskov & Niklas Potrafke, 2012. "Political Ideology and Economic Freedom Across Canadian Provinces," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 38(2), pages 143-166.
    8. ., 2010. "The Korean Economy: Transition to a Knowledge-based Economy," Chapters, in: The Korean Economy in Transition, chapter 4, Edward Elgar Publishing.
    9. Fagerberg, Jan & Srholec, Martin & Verspagen, Bart, 2010. "Innovation and Economic Development," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 2, chapter 0, pages 833-872, Elsevier.
    10. Mohammed Yelwa & S.A.J. Obansa Awe & Emmanuel Omonoyi, 2015. "Informality, Inclusiveness and Economic Growth in Nigeria," International Journal of Management Science and Business Administration, Inovatus Services Ltd., vol. 1(10), pages 33-44, September.
    11. Niklas Potrafke, 2011. "Does government ideology influence budget composition? Empirical evidence from OECD countries," Economics of Governance, Springer, vol. 12(2), pages 101-134, June.
    12. Angus Deaton & Alan Heston, 2010. "Understanding PPPs and PPP-Based National Accounts," American Economic Journal: Macroeconomics, American Economic Association, vol. 2(4), pages 1-35, October.
    13. Nghiem Thi Hong Nhung, 2016. "Optimal Forest Management for Carbon Sequestration: A Case Study of Eucalyptus urophylla and Acacia mangium in Yen Bai Province, Vietnam," EEPSEA Research Report rr2016046, Economy and Environment Program for Southeast Asia (EEPSEA), revised Apr 2016.
    14. Kaushik Basu, 2016. "Beyond the Invisible Hand: Groundwork for a New Economics," Economics Books, Princeton University Press, edition 1, number 9299.
    15. Michikazu Kojima & Etsuyo Michida, 2011. "Trade and the Environment," Chapters, in: Masahisa Fujita & Ikuo Kuroiwa & Satoru Kumagai (ed.), The Economics of East Asian Integration, chapter 18, Edward Elgar Publishing.
    16. Haq, Zahoor Ul & Meilke, Karl D., 2009. "The Role of Income Growth in Emerging Markets and the BRICs in Agrifood Trade," Working Papers 48122, Canadian Agricultural Trade Policy Research Network.
    17. David W. Hutton & Margaret L. Brandeau, 2013. "Too Much of a Good Thing? When to Stop Catch-Up Vaccination," Medical Decision Making, , vol. 33(7), pages 920-936, October.
    18. Aloui, Zouhaier, 2019. "The impact of remittancess on poverty : What relations in Sub-saharan Africa and latin America ?," MPRA Paper 95953, University Library of Munich, Germany.
    19. Nkonya, Ephraim & Phillip, Dayo & Mogues, Tewodaj & Pender, John & Kato, Edward, 2012. "Impacts of Community-driven Development Programs on Income and Asset Acquisition in Africa: The Case of Nigeria," World Development, Elsevier, vol. 40(9), pages 1824-1838.
    20. Takeshima, Hiroyuki & Nkonya, Ephraim M. & Deb, Sayon, 2012. "Impact of fertilizer subsidies on the commercial fertilizer sector in Nigeria:: Evidence from previous fertilizer subsidy schemes," NSSP working papers 23, International Food Policy Research Institute (IFPRI).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0002679. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.