‘Cascades of care’ have emerged as an attractive tool for assessing access to care for numerous chronic diseases, including HIV/AIDS, addiction, diabetes, hepatitis, mental health, and tuberculosis. In this seminar Dr. Haacker will discuss the use of cascades of care in health policy analysis and planning, and will review various examples of its applications.
While the cascade of care framework is conceptualized as a measure of progression to effective care, it is typically represented by cross-sectional data. Based on a general model of disease progression, Dr. Haacker will examine the link between the odds of progression along the cascade of care and corresponding cross-sectional data. Under various circumstances, the discrepancies between the two perspectives are large and the model is used to identify the determinants of such discrepancies. On this basis, the seminar will discuss the use of cascades of care across diseases and populations, evaluate the use of cross-sectional targets in disease control strategies (e.g., the UNAIDS 90-90-90 targets), and address implications for cost-effectiveness analysis.
Markus Haacker is a macroeconomist working in the sphere of global health. Much of his work involves adapting tools and perspectives from macroeconomics or public finance for use in health policy analysis. He has published extensively on the returns to investment and cost-effectiveness of disease control strategies, in particular regarding HIV/AIDS and hepatitis C. He has been a staff member of the IMF and has advised governments and international agencies such as UNAIDS and the World Bank. His book on The Economics of the Global Response to HIV/AIDS was published by Oxford University Press in 2016.