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Michael McFaul, a Stanford political scientist and former U.S. ambassador to Russia, has been selected as the next director of the university’s Freeman Spogli Institute for International Studies.

The announcement was made Wednesday by Stanford Provost John Etchemendy and Ann Arvin, the university’s vice provost and dean of research. McFaul will succeed Mariano-Florentino Cuéllar, who was nominated in July as an associate justice of the California Supreme Court and elected Tuesday.

McFaul takes the helm of FSI in January.

"Stanford has long been a home for scholars who connect academia to policy and public service, and Professor McFaul is the embodiment of that model," Etchemendy said. "We are grateful for Mike's service and confident he will be a strong leader for FSI."

Arvin said McFaul is a strong fit for the position.

“Professor McFaul’s background as an outstanding scholar and his service as an influential ambassador give him a vital perspective to lead FSI, which is Stanford’s hub for studying and understanding international policy issues,” she said. “His scholarship, experience and energy will keep FSI and Stanford at the forefront of international studies as well as some of the most pressing global policy debates."

McFaul has been a faculty member in the department of political science at Stanford since 1994.  He joined the Obama administration in January 2009, serving for three years as Special Assistant to the President and Senior Director for Russian and Eurasian Affairs at the National Security Council at the White House. He then served as U.S. Ambassador to the Russian Federation from 2012 to 2014.

McFaul already has a deep affiliation with FSI. Before joining the government, he served as FSI deputy director from 2006 to 2009.  He also directed FSI’s Center on Democracy, Development, and the Rule of Law (CDDRL) from 2005 to 2009.

During his four years leading CDDRL, McFaul launched the Draper Hills Summer Fellowship program for mid-career lawyers, politicians, advocates and business leaders working to shore up democratic institutions in their home countries. He also established CDDRL’s senior honors program.  From 1992-1994, McFaul also worked as a Senior Research Fellow at FSI’s Center for International Security and Cooperation (CISAC).

“I am thrilled to be assuming a leadership role again at FSI,” McFaul said.  “FSI has become one of the premier institutions in the country for policy-relevant research on international affairs.  I look forward to using my recent government experience to deepen further FSI’s impact on policy debates in Washington and around the world.”

Arvin said McFaul’s previous positions at FSI and CDDRL will make for a smooth transition in the institute’s leadership.

“His familiarity with FSI’s history and infrastructure will allow him to start this new position with an immediate focus on the institute’s academic mission,” she said.

McFaul is also the Peter and Helen Bing Senior Fellow at the Hoover Institution, and plans to build on his long affiliations with both Hoover and FSI to deepen cooperation between these two premier public policy institutions on campus.

He has written and co-authored dozens of books including Advancing Democracy Abroad: Why We Should, How We CanTransitions To Democracy: A Comparative Perspective (with Kathryn Stoner); Power and Purpose: American Policy toward Russia after the Cold War (with James Goldgeier); and Russia’s Unfinished Revolution: Political Change from Gorbachev to Putin.

“In so many ways, Mike represents the best of FSI,” said Cuéllar, who has held leadership positions at FSI since 2004 and begins his term on the California Supreme Court in January. “He knows the worlds of academia and policy extremely well, and will bring unique experience and sound judgment to his new role at FSI.”

McFaul currently serves as a news analyst for NBC News, appearing frequently on NBC, MSNBC, and CNBC as a commentator on international affairs. He also appears frequently on The Charlie Rose Show and The Newshour, as well as PBS and BBC radio programs. He has recently published essays in Foreign AffairsThe New York TimesPolitico, and Time

McFaul was one of the first U.S. ambassadors to actively use social media for public diplomacy. He still maintains an active presence on Facebook at amb.mcfaul and on Twitter at @McFaul.

McFaul received his B.A. in International Relations and Slavic Languages and his M.A. in Russian and East European Studies from Stanford University in 1986.  As a Rhodes Scholar, he completed his D. Phil. in International Relations at Oxford University in 1991.

“Since coming here in 1981 as 17-year-old kid from Montana, Stanford has provided me with tremendous opportunities to grow as a student, scholar, and policymaker,” McFaul said. “I now look forward to giving back to Stanford by contributing to the development of one of the most vital and innovative institutions on campus.” 

 

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Former President George W. Bush met with Stanford students for an hourlong conversation that touched on many of the defining moments and policies of his presidency.

In a relaxed and sometimes self-deprecating exchange on May 5, Bush talked about the limits of congressional power and his relationships and personal diplomacy with other world leaders. His tone was more serious when discussing what he described as universal desires for freedom, his military strategies following 9/11, and his commitment to addressing Africa’s HIV/AIDS pandemic.

Mariano-Florentino Cuéllar, director of the university’s Freeman Spogli Institute for International Studies, moderated the session. Stanford President John Hennessy and Condoleezza Rice – Bush’s secretary of state and national security adviser who has returned to teaching political science and business at Stanford – joined the conversation.

"FSI has a terrific track record of convening leaders at Stanford, from the head of the International Monetary Fund to prime ministers and presidents,” Cuéllar said. “On this occasion, we wanted our students to have an opportunity for a candid conversation with one of the key policymakers of the early 21st century, and we think such experiences will further prepare them for leadership in a complex world."

About 30 students were invited to the session at Encina Hall, but they didn’t know they were meeting Bush until the 43rd president walked into the room.

“I suspect he misses this sort of engagement,” said Gregory Schweizer, a second-year law school student who was part of the discussion that also covered immigration reform, national education policies and the Edward Snowden affair.

“The media always portrays him as being disengaged from current affairs,” Schweizer said. “But I’m impressed with how interested and engaged he still is.”

Along with representatives from Stanford Law School, other students were invited from the Ford Dorsey Program in International Policy Studies. Honors students from FSI’s Center for International Security and Cooperation and Center on Democracy, Development, and the Rule of Law also joined the conversation.

Bush’s visit was arranged with the help of  Brad Freeman, a former university trustee and Ronald Spogli, who is currently on Stanford's board of trustees. Freeman and Spogli are longtime friends of the former president and philanthropists who donated a naming gift to FSI in 2005. Bush appointed Spogli as ambassador to Italy in 2005 and as ambassador to San Marino a year later. 

Stanford has a tradition of hosting current and former heads of state, including German Chancellor Angela Merkel and former Russian President Dmitry Medvedev – both of whom visited in 2010.

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The world’s leading economic policymakers are “on the right track” to ensure a global financial upturn, the chief of the International Monetary Fund told a Stanford audience on Tuesday.

But she warned the recovery will be derailed without the creation of more jobs, better education systems and a way to shrink the gap between rich and poor. And she cautioned against the potential pitfalls of untested exchanges and digital currencies such as Bitcoin.

“We are on the right track, but we need to ask – the right track to where? And the right track to what growth?” said Christine Lagarde, the IMF’s managing director. “Will it be solid, sustainable, and balanced – or will it be fragile, erratic, and unbalanced? To answer this question, we need to look at the patterns of economic activity in the years ahead, and especially the role of technology and innovation in driving us forward.”

Lagarde’s visit to Stanford was co-sponsored by the Freeman Spogli Institute for International Studies and the Stanford Institute for Economic Policy Research. In addition to delivering public remarks at FSI’s Bechtel Conference Center, Lagarde met privately with faculty and students during the day.

Just returning from the G-20 summit in Sydney, Lagarde said she is optimistic that the world’s economic leaders are committed to taking the steps that will guard against another large-scale financial collapse. She said the G-20 members agreed to complete a set of financial reforms by the end of this year, a move that will make the “financial sector safer and less likely to cause crisis.”

She said the member countries and their central banks have also agreed to better cooperate and be more transparent in their policymaking.

But she’s worried that unless more sustainable jobs are created, economic disparities will increase. And that, she said, will “harm the pace and sustainability of growth over the long term.”

As technology has helped create a more interconnected world, it is playing an increasing role in the economic landscape. Machines have made our lives easier. Artificial intelligence has led to cars that can drive themselves, robots that can do things in place of humans and smartphones that are more powerful than the first supercomputers.

But so far, there’s been no measure of how new technology has increased productivity.

“We certainly need to keep an eye on this,” she said. “One of the biggest worries is how this technological innovation affects jobs. Put simply: will machines leave workers behind?”

She said technology creates “huge rewards for the extraordinary visionaries at the top, and huge anxieties for workers at the bottom.”

Lagarde said it is up to educators to better prepare the next generation of workers.

“Educational systems are not keeping pace with changing technology and the ever-evolving world of work,” she said. “We need to change what people learn, how people learn, when people learn, and even why people learn. We must go beyond the traditional model of students sitting in classrooms, following instructions and memorizing material. Computers can do that.”

Instead, humans must “outclass computers” in cognitive, interpersonal and sophisticated coding skills, she said.

“Think of creative jobs, caring jobs, jobs that entail great craftsmanship – imagination,” she said. “And given the rate and pace of change, we will need the ability to constantly adapt and change through lifelong learning.”

She called on institutions such as Stanford to play a key role in the process.

“Stanford’s model of education was innovative from the very first day—co-educational, non-denominational, and always practical, focusing on the formation of cultured and useful citizens,” she said. “Stanford was ahead of its time back then. I know that it will continue to be ahead of its time as we venture into the exciting period ahead.”

But that exciting period carries with it uncertainty and risk.

Asked about the role that emerging digital currencies such as Bitcoin could have on the evolving economy, Lagarde was skeptical, calling it a “shaky and wobbly” system.

The currency’s trading website went offline this week, spooking investors and calling into question Bitcoin’s future.

“It’s a glamorous, sexy attractive new system,” she said. “But a monetary system is a public good. It has to be supervised and sufficiently regulated so it is accountable. At this point in time, I think Bitcoin is outside that perimeter of both supervision and regulation.”

Lagarde is the 11th managing director of the IMF, and the first woman to lead the 188-country organization. Since she took over the organization in 2011, she has played a role in the world’s most pressing financial matters, working on solutions to a sluggish global economy and the debt crises in Europe.

The IMF gives both policy advice and financing to countries in difficult economic situations. It also helps developing countries reduce poverty and become more economically stable. 

The organization is now poised to assist Ukraine, which is at risk of running out of money to pay its bills in the midst of a political crisis. The country is struggling to cobble together a temporary government in the wake of President Viktor Yanukovych leaving Kiev and being removed from power.

But until a provisional government is formed, the country cannot technically ask for help. When it does, Lagarde said the IMF will send “technical assistance.”

“We are ready to engage,” she said.

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Political and economic transition is often blamed for Russia’s 40% surge in deaths between 1990 and 1994 (the “Russian Mortality Crisis”). Highlighting that increases in mortality occurred primarily among alcohol- related causes and among working-age men (the heaviest drinkers), this paper investigates a different explanation: the demise of the 1985-1988 Gorbachev Anti-Alcohol Campaign. We use archival sources to build a new oblast-year data set spanning 1970-2000 and find that:

  • The campaign was associated with substantially fewer campaign year deaths,
  • Oblasts with larger reductions in alcohol consumption and mortality during the campaign experienced larger transition era increases, and
  • Other former Soviet states and Eastern European countries exhibit similar mortality patterns commensurate with their campaign exposure.

The campaign’s end explains between 32% and 49% of the mortality crisis, suggesting that Russia’s transition to capitalism and democracy was not as lethal as commonly suggested.

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American Economic Journal: Applied Economics
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Jay Bhattacharya
Jay Bhattacharya
Christina Gathmann
Grant Miller
Grant Miller
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Prisons of the former Soviet Union (FSU) have high rates of multidrug-resistant tuberculosis (MDR-TB) and are thought to drive general population tuberculosis (TB) epidemics. Effective prison case detection, though employing more expensive technologies, may reduce long-term treatment costs and slow MDR-TB transmission.

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PLoS Medicine
Authors
DE Winetsky
DM Negoescu
EH DeMarchis
O Almukhamedova
A Dooronbekova
D Pulatov
N Vezhnina
Douglas K. Owens
Douglas Owens
Jeremy Goldhaber-Fiebert
Jeremy Goldhaber-Fiebert
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Background: Prisons of the former Soviet Union (FSU) have high rates of multidrug-resistant tuberculosis (MDR-TB) and are thought to drive general population tuberculosis (TB) epidemics. Effective prison case detection, though employing more expensive technologies, may reduce long-term treatment costs and slow MDR-TB transmission.

Methods and Findings: We developed a dynamic transmission model of TB and drug resistance matched to the epidemiology and costs in FSU prisons. We evaluated eight strategies for TB screening and diagnosis involving, alone or in combination, self-referral, symptom screening, mass miniature radiography (MMR), and sputum PCR with probes for rifampin resistance (Xpert MTB/RIF). Over a 10-y horizon, we projected costs, quality-adjusted life years (QALYs), and TB and MDR-TB prevalence. Using sputum PCR as an annual primary screening tool among the general prison population most effectively reduced overall TB prevalence (from 2.78% to 2.31%) and MDR-TB prevalence (from 0.74% to 0.63%), and cost US$543/QALY for additional QALYs gained compared to MMR screening with sputum PCR reserved for rapid detection of MDR-TB. Adding sputum PCR to the currently used strategy of annual MMR screening was cost-saving over 10 y compared to MMR screening alone, but produced only a modest reduction in MDR-TB prevalence (from 0.74% to 0.69%) and had minimal effect on overall TB prevalence (from 2.78% to 2.74%). Strategies based on symptom screening alone were less effective and more expensive than MMR-based strategies. Study limitations included scarce primary TB time-series data in FSU prisons and uncertainties regarding screening test characteristics.

Conclusions: In prisons of the FSU, annual screening of the general inmate population with sputum PCR most effectively reduces TB and MDR-TB prevalence, doing so cost-effectively. If this approach is not feasible, the current strategy of annual MMR is both more effective and less expensive than strategies using self-referral or symptom screening alone, and the addition of sputum PCR for rapid MDR-TB detection may be cost-saving over time. 

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PLoS Medicine
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Winetsky DE
Negoescu DM
Almukhamedova O
DeMarchis E
Dooronbekova A
Pulatov D
Vezhnina N
Zhussupov B
Douglas K. Owens
Douglas K. Owens
Jeremy Goldhaber-Fiebert
Jeremy Goldhaber-Fiebert
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Adam Gorlick
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Those who live and die behind prison walls don’t usually get much public attention. Incarceration is, after all, meant to remove criminals from society. But contagious and potentially deadly diseases can’t be locked and left in a penitentiary, especially when infected inmates are eventually released.

The problem of prisoners and ex-convicts transmitting diseases to the general population is especially bad in the countries of the former Soviet Union, where rates of tuberculosis and drug-resistant strains of TB are among the world’s highest.

But Stanford researchers have identified solutions that could help curb tuberculosis in Russia, Latvia, Tajikistan and the 12 other countries in the region. Led by Jeremy Goldhaber-Fiebert, an assistant professor of medicine, the team has shown that a genetic TB and drug resistance screening tool called GeneXpert is more cost effective and better at reducing the spread of the disease than other methods currently recommended by the World Health Organization. Their findings were published online Nov. 27 in PLoS Medicine.

“Tuberculosis doesn’t stop at any border or any locked gate,” said Goldhaber-Fiebert, who is also a faculty member at Stanford Health Policy, a research center at the university’s Freeman Spogli Institute for International Studies.

“Drug-resistant TB is rampant in prisons,” he said. “When infected prisoners get out, they are thought to drive the TB epidemic in the general population. We are looking to find better ways to deal with that.”

About 400,000 cases of TB were diagnosed last year in the 15 former Soviet Union states – 40 times the number reported in the United States. Nearly 80,000 of the sick had drug-resistant TB. According to several studies, the prevalence of TB among the region’s prisoners is 10 times greater than that of the general population.

The WHO suggests three ways to screen for TB in prisons: relying on inmates to report symptoms, actively interviewing prisoners about their health, and administering chest X-rays. The organization doesn’t recommend one method over another, and currently, prisoners in the former Soviet Union are screened annually with miniature chest X-rays.

While X-rays can show whether a lung looks healthy, they don’t always catch TB. And when they do, they cannot differentiate between a TB that can be cured with standard medications and its drug-resistant cousins that require more expensive and extensive treatments.

That’s where GeneXpert has an upper hand.

Since it was introduced in 2005, the diagnostic has been hailed as a potentially powerful tool that can help to cut TB and drug-resistance rates by more accurately diagnosing people and getting them treated. With just a small sample of mucous analyzed by a machine, the GeneXpert system can instantly detect TB and its drug-resistant genetic mutations, well suited to mass screening within the prison systems of the former Soviet Union.

But the GeneXpert test is more expensive than alternative screening methods. And while it promises to be more effective, its impact on total costs had not been quantified in the former Soviet Union region until Goldhaber-Fiebert and his colleagues began their work nearly three years ago.

By developing computer models of the former Soviet Union’s prison populations, the team predicted that using GeneXpert can cut the prevalence of TB among inmates by about 20 percent within four years – provided the screening is combined with standard regimens of drug treatment for infected patients and for those with drug-resistant TB.

“For this to make sense, you need to have the right drugs to cure those individuals you identify,” Goldhaber-Fiebert said.

The additional cost of screening with GeneXpert averages to $71 per prisoner compared to the next best alternative approach, he said.

When compared to the decreases in illness and increases in survival, and factoring the financial and societal costs of TB in the broader population, the method makes good economic sense, he said.

“There is a large, direct value to using this technology for screening in prison settings, and there are potentially substantial secondary benefits to the general population of the former Soviet Union and to the world,” Goldhaber-Fiebert said.

Douglas K. Owens, a professor of medicine who is one of the paper’s co-authors and director of Stanford Health Policy, said the findings could give governments and medical experts the evidence they need to change the way they tackle TB.

“This is the kind of work we hope will inform policymaking about TB control,” Owens said. “We’ve shown there’s a more effective approach for trying to catch TB in prisons, and that means a better chance for preventing the disease from spreading.”

Co-authors on the PLoS Medicine paper also include former Stanford medical student Daniel Winetsky and current Stanford doctoral student in Management Science and Engineering, Diana Negoescu.

The researchers collaborated with the AIDS Foundation East-West. Funding for the study came from Äids Fonds, the International Research & Exchanges Board, the Department of Veterans Affairs, the National Institutes of Health, and Stanford.

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Political and economic transition is often blamed for Russia’s 40% surge in deaths between 1990 and 1994. Highlighting that increases in mortality occurred primarily among alcohol-related causes and among working-age men (the heaviest drinkers), this paper investigates an alternative explanation: the demise of the 1985-1988 Gorbachev Anti-Alcohol Campaign. Using archival sources to build a new oblast-year data set spanning 1978-2000, we find a variety of evidence suggesting that the campaign’s end explains a large share of the mortality crisis – implying that Russia’s transition to capitalism and democracy was not as lethal as commonly suggested.

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NBER
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Jay Bhattacharya
Jay Bhattacharya
Christina Gathmann
Grant Miller
Grant Miller
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Abstract

BACKGROUND:

Injection drug use (IDU) and heterosexual virus transmission both contribute to the growing mixed HIV epidemics in Eastern Europe and Central Asia. In Ukraine-chosen in this study as a representative country-IDU-related risk behaviors cause half of new infections, but few injection drug users (IDUs) receive methadone substitution therapy. Only 10% of eligible individuals receive antiretroviral therapy (ART). The appropriate resource allocation between these programs has not been studied. We estimated the effectiveness and cost-effectiveness of strategies for expanding methadone substitution therapy programs and ART in mixed HIV epidemics, using Ukraine as a case study.

METHODS AND FINDINGS:

We developed a dynamic compartmental model of the HIV epidemic in a population of non-IDUs, IDUs using opiates, and IDUs on methadone substitution therapy, stratified by HIV status, and populated it with data from the Ukraine. We considered interventions expanding methadone substitution therapy, increasing access to ART, or both. We measured health care costs, quality-adjusted life years (QALYs), HIV prevalence, infections averted, and incremental cost-effectiveness. Without incremental interventions, HIV prevalence reached 67.2% (IDUs) and 0.88% (non-IDUs) after 20 years. Offering methadone substitution therapy to 25% of IDUs reduced prevalence most effectively (to 53.1% IDUs, 0.80% non-IDUs), and was most cost-effective, averting 4,700 infections and adding 76,000 QALYs compared with no intervention at US$530/QALY gained. Expanding both ART (80% coverage of those eligible for ART according to WHO criteria) and methadone substitution therapy (25% coverage) was the next most cost-effective strategy, adding 105,000 QALYs at US$1,120/QALY gained versus the methadone substitution therapy-only strategy and averting 8,300 infections versus no intervention. Expanding only ART (80% coverage) added 38,000 QALYs at US$2,240/QALY gained versus the methadone substitution therapy-only strategy, and averted 4,080 infections versus no intervention. Offering ART to 80% of non-IDUs eligible for treatment by WHO criteria, but only 10% of IDUs, averted only 1,800 infections versus no intervention and was not cost effective.

CONCLUSIONS:

Methadone substitution therapy is a highly cost-effective option for the growing mixed HIV epidemic in Ukraine. A strategy that expands both methadone substitution therapy and ART to high levels is the most effective intervention, and is very cost effective by WHO criteria. When expanding ART, access to methadone substitution therapy provides additional benefit in infections averted. Our findings are potentially relevant to other settings with mixed HIV epidemics. Please see later in the article for the Editors' Summary.

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PLoS Medicine
Authors
Alistar, S. S.
Douglas K. Owens
Douglas Owens
Margaret L. Brandeau
Margaret Brandeau
Paragraphs

Background Injection drug use (IDU) and heterosexual virus transmission both contribute to the growing mixed HIV epidemics in Eastern Europe and Central Asia. In Ukraine—chosen in this study as a representative country—IDU-related risk behaviors cause half of new infections, but few injection drug users (IDUs) receive methadone substitution therapy. Only 10% of eligible individuals receive antiretroviral therapy (ART). The appropriate resource allocation between these programs has not been studied. We estimated the effectiveness and cost-effectiveness of strategies for expanding methadone substitution therapy programs and ART in mixed HIV epidemics, using Ukraine as a case study.

Methods and Findings We developed a dynamic compartmental model of the HIV epidemic in a population of non-IDUs, IDUs using opiates, and IDUs on methadone substitution therapy, stratified by HIV status, and populated it with data from the Ukraine. We considered interventions expanding methadone substitution therapy, increasing access to ART, or both. We measured health care costs, quality-adjusted life years (QALYs), HIV prevalence, infections averted, and incremental cost-effectiveness. Without incremental interventions, HIV prevalence reached 67.2% (IDUs) and 0.88% (non-IDUs) after 20 years. Offering methadone substitution therapy to 25% of IDUs reduced prevalence most effectively (to 53.1% IDUs, 0.80% non-IDUs), and was most cost-effective, averting 4,700 infections and adding 76,000 QALYs compared with no intervention at US$530/QALY gained. Expanding both ART (80% coverage of those eligible for ART according to WHO criteria) and methadone substitution therapy (25% coverage) was the next most cost-effective strategy, adding 105,000 QALYs at US$1,120/QALY gained versus the methadone substitution therapy-only strategy and averting 8,300 infections versus no intervention. Expanding only ART (80% coverage) added 38,000 QALYs at US$2,240/QALY gained versus the methadone substitution therapy-only strategy, and averted 4,080 infections versus no intervention. Offering ART to 80% of non-IDUs eligible for treatment by WHO criteria, but only 10% of IDUs, averted only 1,800 infections versus no intervention and was not cost effective.

Conclusions Methadone substitution therapy is a highly cost-effective option for the growing mixed HIV epidemic in Ukraine. A strategy that expands both methadone substitution therapy and ART to high levels is the most effective intervention, and is very cost effective by WHO criteria. When expanding ART, access to methadone substitution therapy provides additional benefit in infections averted. Our findings are potentially relevant to other settings with mixed HIV epidemics.

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Publication Type
Journal Articles
Publication Date
Journal Publisher
PLoS Med
Authors
Sabina S. Alistar
Douglas K. Owens
Douglas Owens
Margaret L. Brandeau
Margaret Brandeau
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