What does it cost? An economic analysis of a harm reduction intervention in Svetlogorsk, Belarus

Given the expanding HIV epidemic among injecting drug users (IDUs) in Eastern Europe, there is a greater focus on harm reduction activities among IDUs. The aim of this study was to undertake an economic analysis of a harm reduction intervention in Belarus. The paper examines the nature and implementation of project activities, measures the costs of these activities, and then highlights key factors influencing the replication of these activities elsewhere. The cost analysis was performed to assess the resources required to implement the project and its unit costs. The main activities were: promotion of safe use of syringes; collection of dirty needles; promotion of safe sex; medical assistance in case of sexually transmitted diseases; psychological and legal support; and outreach services by volunteers. Total financial and economic costs were $28, 524 and $32,768, respectively. When donated mass media services were included, economic costs total $148,617. The financial and economic (with mass media) unit costs ranged from $0.32 to 1.68 per disposable syringe distributed and $0.98 to 5.10 per contact. Total costs were sensitive to the valuation of mass media services. However, it is unclear to what extent mass media would have been used if the project had borne the costs. This issue is crucial when considering the sustainability and replication of similar projects elsewhere.