Investments to Combat HIV, Tuberculosis, and Malaria: Effects on Primary Healthcare (2000–2023)

by Jiaying Stephanie Su, John Stover, Carel Pretorius, Peter Winskill, Sedona Sweeney, Timothy B. Hallett, Nicolas A.

Menzies Background Global investments to combat HIV, tuberculosis, and malaria (HTM) have delivered substantial health gains and may have reduced the burden placed by these diseases on the routine health system. We estimated the reduction in primary healthcare (PHC) utilization resulting from the scale-up of HTM services over 2000–2023 in 108 low- and middle-income countries.

Methods and findings For each disease, we applied established mathematical models to quantify PHC utilization (outpatient visits and inpatient bed-days provided outside of HTM programs) by individuals with symptomatic HIV, tuberculosis, or malaria unable to access HTM-specific services. For each country, we estimated averted PHC utilization by comparing a scenario describing the actual scale-up of HTM services to a counterfactual scenario holding HTM service coverage constant at year 2000 levels.

We applied published unit costs to estimate the averted costs resulting from reduced PHC utilization.