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Table 4 Sensitivity analysis of human resources needs and salary costs for initiating all those eligible for antiretroviral therapy (ART) and maintaining them on ART for one year, under different treatment strategies

From: Human resources needs for universal access to antiretroviral therapy in South Africa: a time and motion study

  Human resources needs Costs
  Nurse- months × 1,000 (95% CI) Nurse- FTEs × 1,000 (95% CI) Counselor- months × 1,000 (95% CI) Counselor FTEs × 1,000 (95% CI) Doctor- months × 1,000 (95% CI) Doctor FTEs × 1,000 (95% CI) Total salary costs in million ZAR (95% CI) Proportion of current HIV sector budget, % (95% CI)a
Most efficient clinic (clinic B)        
CD4 ≤200 10 (7 to 13) 0.8 (0.6 to 1.1) 17 (10 to 24) 1.4 (0.9 to 2.0) 1 (1 to 1) 0.1 (0.1 to 0.1) 339 (223 to 456) 2 (2 to 3)
CD4 ≤350 (TB or pregnant); CD4 ≤200 (all other HIV-infected people) 13 (9 to 17) 1.1 (0.7 to 1.4) 22 (14 to 31) 1.9 (1.1 to 2.6) 1 (1 to 2) 0.1 (0.1 to 0.1) 445 (292 to 597) 3 (2 to 4)
CD4 ≤350 22 (15 to 29) 1.8 (1.2 to 2.3) 38 (23 to 53) 3.2 (1.9 to 4.4) 2 (2 to 3) 0.2 (0.1 to 0.2) 760 (499 to 1,019) 5 (4 to 7)
CD4 ≤500 42 (29 to 56) 3.5 (2.4 to 4.7) 73 (45 to 101) 6.1 (3.7 to 8.4) 4 (3 to 6) 0.4 (0.3 to 0.5) 1,459 (959 to 1,959) 10 (7 to 14)
All HIV-positive people 63 (42 to 84) 5.2 (3.5 to 7.0) 108 (66 to 150) 9.0 (5.5 to 12.5) 6 (5 to 8) 0.5 (0.4 to 0.7) 2,159 (1,419 to 2,899) 15 (10 to 21)
Least efficient clinic (clinic C)        
CD4 ≤200 15 (10 to 20) 1.2 (0.8 to 1.6) 28 (17 to 38) 2.3 (1.4 to 3.2) 2 (2 to 3) 0.2 (0.2 to 0.3) 559 (369 to 749) 4 (3 to 5)
CD4 ≤350 (TB or pregnant); CD4 ≤200 (all other HIV-infected people) 19 (13 to 26) 1.6 (1.1 to 2.2) 36 (22 to 50) 3.0 (1.8 to 4.2) 3 (2 to 4) 0.3 (0.2 to 0.4) 732 (483 to 981) 5 (3 to 7)
CD4 ≤350 33 (22 to 44) 2.8 (1.9 to 3.7) 62 (38 to 86) 5.1 (3.1 to 7.1) 6 (4 to 7) 0.5 (0.3 to 0.6) 1,250 (825 to 1,675) 9 (6 to 12)
CD4 ≤500 63 (43 to 85) 5.3 (3.6 to 7.1) 118 (72 to 165) 9.9 (6.0 to 13.7) 11 (8 to 14) 0.9 (0.6 to 1.1) 2,401 (1,584 to 3,218) 17 (11 to 23)
All HIV-positive people 94 (63 to 126) 7.9 (5.3 to 10.5) 175 (107 to 243) 14.6 (8.9 to 20.3) 16 (11 to 20) 1.3 (0.9 to 1.7) 3,552 (2,344 to 4,762) 25 (17 to 34)
Increasing returns to scale        
CD4 ≤200 11 (8 to 15) 1.0 (0.6 to 1.3) 20 (12 to 27) 1.6 (1.0 to 2.3) 1 (1 to 2) 0.1 (0.1 to 0.2) 404 (266 to 541) 3 (2 to 4)
CD4 ≤350 (TB or pregnant); CD4 ≤200 (all other HIV-infected people) 15 (10 to 20) 1.2 (0.8 to 1.6) 26 (16 to 36) 2.1 (1.3 to 3.0) 2 (1 to 3) 0.2 (0.1 to 0.2) 524 (345 to 702) 4 (2 to 5)
CD4 ≤350 25 (17 to 33) 2.1 (1.4 to 2.7) 43 (26 to 59) 3.5 (2.2 to 4.9) 3 (2 to 4) 0.3 (0.2 to 0.3) 871 (574 to 1,168) 6 (4 to 8)
CD4 ≤500 45 (30 to 59) 3.7 (2.5 to 4.9) 77 (47 to 107) 6.4 (3.9 to 8.9) 6 (4 to 7) 0.5 (0.3 to 0.6) 1,576 (1,039 to 2,113) 11 (7 to 15)
All HIV-positive people 62 (42 to 82) 5.2 (3.5 to 6.9) 107 (65 to 149) 8.9 (5.5 to 12.4) 8 (6 to 10) 0.7 (0.5 to 0.8) 2,196 (1,449 to 2,946) 16 (10 to 21)
  1. CD4 = CD4 cell count (expressed as cells/μl); FTE, full-time equivalent; ZAR = South African rand.
  2. The underlying number of patients needing treatment are based on the WHO-reported ART treatment coverage in South Africa [23] and UNAIDS-reported point estimate of the total number of people infected with HIV [66], see Table 2.
  3. aCurrent total expenditure: estimate of the total amount spent on preventing and treating HIV in South Africa in 2009 (ZAR 14 billion) [66].