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dc.contributor.advisorBloom, David E.
dc.contributor.authorChen, Simiao
dc.date.accessioned2018-12-20T13:45:14Z
dash.embargo.terms2018-11-01
dc.date.created2018-05
dc.date.issued2018-04-20
dc.date.submitted2018
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:37945602*
dc.description.abstractThis thesis explores the economics of a prospective human immunodeficiency virus (HIV) vaccine in terms of: a) its cost-effectiveness in South Africa, and b) the opportunity cost of diverting vaccine R&D funds from other HIV prevention and control activities in South Africa. First, I use a mathematical and economic model of HIV vaccination in South Africa, exploring the cost-effectiveness of HIV vaccines with different attributes. I find that 1) vaccines with moderate initial efficacy but longer durations and smaller decay rates may have the same cost-effectiveness as a vaccine with high initial efficacy but short duration; 2) the vaccine’s cost-effectiveness decreases only slightly with higher vaccine coverage but dramatically with lower prevalence rate; and 3) more than one-third of the total benefit of a vaccine comes from its positive externality. Second, I compare the HIV vaccination as a potential preventive intervention versus PrEP. I find that 1) a vaccine with 60% initial efficacy, an 8-year duration, and a decay rate of γ = 3 is less effective than PrEP in reducing HIV prevalence and incidence from 2021 to 2035; 2) if PrEP has an efficacy of 90%, then we should charge a Thai Trial vaccine below $63, and an HVTN702 vaccine below $100 to make it preferable to PrEP. Finally, I examine the economic return on investing in R&D of an HIV vaccine, by comparing the return (in terms of infections averted) to the same level of investment into increasing uptake of existing HIV preventive interventions instead (ART, MMC and PrEP). I find that 1) the attributes of an HIV vaccine, and the probability of realizing them through R&D investment, determines the attractiveness of such investment relative to spending on alternative HIV interventions; and 2) a vaccine is much more preferable if the initial coverage of alternative interventions is higher.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dash.licenseLAA
dc.subjectHealth Sciences, Public Health
dc.subjectEconomics, General
dc.titleEconomics of HIV Vaccines and HIV Vaccine Research and Development
dc.typeThesis or Dissertation
dash.depositing.authorChen, Simiao
dash.embargo.until2018-11-01
dc.date.available2018-12-20T13:45:14Z
thesis.degree.date2018
thesis.degree.grantorHarvard T.H. Chan School of Public Health
thesis.degree.levelDoctoral
thesis.degree.nameDoctor of Science (SD)
dc.contributor.committeeMemberCanning, David
dc.contributor.committeeMemberBärnighausen, Till
dc.type.materialtext
thesis.degree.departmentGlobal Health and Population
dash.identifier.vireohttp://etds.lib.harvard.edu/hsph/admin/view/221
dc.description.keywordsEconomics; HIV vaccine; cost effectiveness; HIV vaccine research and development;
dash.author.emailsic104@mail.harvard.edu


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