Data from: Exploring the potential health impact and cost-effectiveness of AIDS vaccine within a comprehensive HIV/AIDS response in low- and middle-income countries

Background: The Investment Framework Enhanced (IFE) proposed in 2013 by
the Joint United Nations Programme on HIV/AIDS (UNAIDS) explored how
maximizing existing interventions and adding emerging prevention options,
including a vaccine, could further reduce new HIV infections and
AIDS-related deaths in low- and middle-income countries (LMICs). This
article describes additional modeling which looks more closely at the
potential health impact and cost-effectiveness of AIDS vaccination in
LMICs as part of UNAIDS IFE. Methods: An epidemiological model was used to
explore the potential impact of AIDS vaccination in LMICs in combination
with other interventions through 2070. Assumptions were based on
perspectives from research, vaccination and public health experts, as well
as observations from other HIV/AIDS interventions and vaccination
programs. Sensitivity analyses varied vaccine efficacy, duration of
protection, coverage, and cost. Results: If UNAIDS IFE goals were fully
achieved, new annual HIV infections in LMICs would decline from 2.0
million in 2014 to 550,000 in 2070. A 70% efficacious vaccine introduced
in 2027 with three doses, strong uptake and five years of protection would
reduce annual new infections by 44% over the first decade, by 65% the
first 25 years and by 78% to 122,000 in 2070. Vaccine impact would be much
greater if the assumptions in UNAIDS IFE were not fully achieved. An AIDS
vaccine would be cost-effective within a wide range of scenarios.
Interpretation: Even a modestly effective vaccine could contribute
strongly to a sustainable response to HIV/AIDS and be cost-effective, even
with optimistic assumptions about other interventions. Higher efficacy
would provide even greater impact and cost-effectiveness, and would
support broader access. Vaccine efficacy and cost per regimen are critical
in achieving cost-effectiveness, with cost per regimen being particularly
critical in low-income countries and at lower efficacy levels.