World Bank: Estimation of Cost-Savings of NSEP in Malaysia

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Malaysia has recorded a cumulative total of over 98,000 persons infected with HIV by the end of 2012. The number of recorded cases of HIV infection in Malaysia is highest among people who inject drugs (PWID) which constitutes 67 per cent of the total cumulative cases. In the effort to mitigate the HIV transmission among PWID, the government of Malaysia initiated harm reduction programme comprising the Needle Syringe Programme (NSP) and Methadone Maintenance Therapy (MMT) in 2006. Since its inception as a National Pilot Project in 2006, the funding for the programmes has gradually been increased to increase the coverage of these programmes. During the phase of the harm reduction programme, the NSP was carried out by non-governmental organisations affiliated with the Malaysian AIDS Council whilst the MMT was provided by medical practitioners in the public and private health sectors.

Since then the MMT programme has been expanded into the non-health sector and is being implemented by the prisons and the National Anti-Drug Agencies (NADA). By the end of 2011, the Malaysian government has invested a total of RM69.3 million for harm reduction programme. Despite the official recognition that the harm reduction programme may have been successful in reducing HIV transmission, concerns have been raised that public funding for these activities may not be sustainable in the long run and sources of alternative funding is desired.

Thus, an assessment of the economic impact and cost-effectiveness of this programme is very much needed. This project aimed to assess whether the harm reduction programme in Malaysia, which consists of NSP and MMT programmes amongst PWID, have been cost-effective from the perspective of the government by estimating savings in direct health care cost to the government resulting from infections that were averted as a result of the NSP and MMT programmes.

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