Principal Researchers, Boston University Affiliates
Dr Gesine Meyer-Rath [Associate Professor ]

Prof. Gesine Meyer-Rath, MD, PhD, is a medical doctor and health economist working on the economics of infectious disease interventions in low- and middle-income settings. She is an Associate Professor at the Department for Global Health, Boston University, US. She has been resident in South Africa since 2006 and joined HE2RO in 2009. Her focus lies on modelling methods for economic evaluation and translating research into recommendations for public policy. Most of her work has centred on providing recommendations and budgets based on economic analysis for the South African HIV programme, including a well-used budget impact model for ART, the National ART Cost Model, work on optimising HIV testing modalities and prevention interventions, and leading the modelling work on the South African HIV Investment Case. Since March 2020 she has been part of the National Covid-19 Modelling Consortium Most of which she has modelled the cost and budget impact of Covid-19 related interventions, including vaccination. She is the author of over 40 peer-reviewed articles and several book chapters on HIV economics. She holds an MD/PhD from Humboldt University and Free University, Berlin, Germany, and a PhD in Health Economics at the London School of Hygiene and Tropical Medicine.
Projects
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Supporting the South African HIV/TB Investment Case
Since 2011, UNAIDS and other international organisations have prompted countries to counter the downward trend in international funding for HIV programmes by developing an investment case for their national HIV responses. These cases aim to maximise the impact of programmes on HIV incidence and deaths by correcting any mismatch between the epidemic and the response, identifying how to go to the required scale and maintain it, cutting unnecessary costs and diversions of capacity while generating -
Analysing the Impact and Cost of Scaling up Xpert MTB/RIF Technology for TB Diagnosis: The National TB Cost Model (NTCM)
In the South African context, smear microscopy and other conventional TB diagnostic technologies that have been used for decades, are no longer reliable, because many HIV-positive tuberculosis patients are smear-negative, and the long time to diagnosis means that many patients die without having started TB treatment. In December 2010 the GeneXpert System using the Xpert MTB/RIF assay received a strong recommendation from the World Health Organization as the initial test in individuals with HIV -
Building HIV Financial Planning and Budgeting Capacity at Provincial Level: The FIN-CAP Project
While treatment guidelines and the overall funding envelope for antiretroviral treatment in South Africa are decided at the level of the national department of health, the implementation of programmes is the responsibility of each of the nine provinces. In the past, implementation was jeopardized by the lack of capacity for financial planning, expenditure tracking and performance monitoring at the level of provincial HIV and finance managers. The FIN-CAP project, implemented by staff from -
Modelling the Cost of the National ART Programme under Different Sets of Guidelines: The National ART Cost Model (NACM) and the Treatment as Prevention Cost Model (TasP Cost Model)
On request of the South African Department of Health (NDoH), since 2009 HE2RO has used the detailled cost and outcomes data collected in other projects to develop mathematical models projecting the size of the treatment cohort under different scenarios of antiretroviral treatment (ART eligibility as well as the resulting costs). Our budget models, most notably the National ART Cost Model (NACM) and the Treatment as Prevention Cost Model (TasP Cost Model), have contributed to several sets of -
Second and Third-Line Antiretroviral Regimens
As South Africa continues its rapid expansion of access to first-line antiretroviral therapy (ART), more patients will need to be switched to second-line therapy as these first-line regimens fail. However, with little experience with second-line treatments in resource-limited settings, it is not clear how well patients will do on these medications if their first regimen fails. As the cost of second-line medications is much higher than first-line, it is critical to evaluate whether these
Publications
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Syndromic Management vs Point-of-Care, and Lab Based Testing for Chlamydia and Gonorrhoea: a Cost Comparison
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South African Health Review 2016 – Chapter 17
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SA HIV TB Investment Case Summary Report
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SA HIV TB Investment Case Full Report
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The Impact of Company-Level ART Provision to a Mining Workforce in South Africa: A Cost–Benefit Analysis
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Satellite Session at SA AIDS: South Africa’s Investment Case: What are the country’s “best buys” for HIV and TB?
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Brief review of 2014 Medium Term Budget Policy Statement from an HIV and AIDS perspective
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Resource utilization and costs of care prior to ART initiation for pediatric patients in Zambia. AIDS Research and Treatment
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Attrition through Multiple Stages of HIV Care in South Africa
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The cost effectiveness of expansion options for adult ART in South Africa: Integrating economic considerations with epidemiological models of Treatment as Prevention
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Reflecting on health, HIV/AIDS and TB budgets and services in South Africa: Review of the 2014 South African National Budget
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Cost-effectiveness of tenofovir gel in urban South Africa: model projections of HIV impact and threshold product prices
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Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models.
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Changing the South African HIV and TB guidelines: The role of cost modelling
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The Health Economics and Epidemiology Research Office (HE2RO): An overview of research methods and results
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HE2RO’S Overview of Research 2012-2013
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Retention in Care and Outpatient Costs for Children Receiving Antiretroviral Therapy in Zambia: A Retrospective Cohort Analysis
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Company-level provision of universal HIV testing and treatment in a mining workforce in South Africa is cost-saving
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Diagnosing Xpert MTB/RIF negative TB suspects: Impact and cost of an alternative algorithm
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What To Do with Xpert Negatives? The Cost of Alternative Diagnostic Algorithms for TB Suspects Who Are Xpert MTB Negative in a High HIV/MDR-TB Burden Setting
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What to do with Xpert negatives? The cost of alternative diagnostic algorithms for TB suspects who are Xpert MTB negative in a high HIV/MDR-TB burden setting