The Impact of AIDS on Government Service Delivery: The Case of the Zambia Wildlife Authority

Background: The loss of working-aged adults to HIV/AIDS has been shown to increase the costs of labor to the private sector in Africa. There is little corresponding evidence for the public sector. This study evaluated the impact of AIDS on the capacity of a government agency, the Zambia Wildlife Authority (ZAWA), to patrol Zambia’s national parks. Methods: Data were collected from ZAWA on workforce characteristics, recent mortality, costs, and the number of days spent on patrol between 2003 and 2005 by a sample of 76 current patrol officers (reference subjects) and 11 patrol officers who died of AIDS or suspected AIDS (index subjects). An estimate was made of the impact of AIDS on service delivery capacity and labor costs and the potential net benefits of providing treatment. Results: Reference subjects spent an average of 197.4 days on patrol per year. After adjusting for age, years of service, and worksite, index subjects spent 62.8 days on patrol in their last year of service (68% decrease, p<0.0001), 96.8 days on patrol in their second to last year of service (51% decrease, p<0.0001), and 123.7 days on patrol in their third to last year of service (37% decrease, p<0.0001). For each employee who died, ZAWA lost an additional 111 person-days for management, funeral attendance, vacancy, and recruitment and training of a replacement, resulting in a total productivity loss per death of 2.0 person-years. Each AIDS-related death also imposed budgetary costs for care, benefits, recruitment, and training equivalent to 3.3 years’ annual compensation. In 2005, AIDS reduced service delivery capacity by 6.2% and increased labor costs by 9.7%. If antiretroviral therapy could be provided for $500/patient/year, net savings to ZAWA would approach $285,000/year. Conclusion: AIDS is constraining ZAWA’s ability to protect Zambia’s wildlife and parks. Impacts on this government agency are substantially larger than have been observed in the private sector. Provision of ART would result in net budgetary savings to ZAWA and greatly increase its service delivery capacity.

How Much Does It Cost to Provide Antiretroviral Therapy for HIV/AIDS in Africa?

Background: Many African countries are rapidly expanding HIV/AIDS treatment programs. Empirical information on the cost of delivering antiretroviral therapy (ART) for HIV/AIDS is needed for program planning and budgeting. Methods: We searched published and gray sources for estimates of the cost of providing ART in service delivery (non-research) settings in sub-Saharan Africa. Estimates were included if they were based on primary local data for input prices. Results: 17 eligible cost estimates were found. Of these, 10 were from South Africa. The cost per patient per year ranged from $396 to $2,761. It averaged approximately $850/patient/year in countries outside South Africa and $1,700/patient/year in South Africa. The most recent estimates for South Africa averaged $1,200/patient/year. Specific cost items included in the average cost per patient per year varied, making comparison across studies problematic. All estimates included the cost of antiretroviral drugs and laboratory tests, but many excluded the cost of inpatient care, treatment of opportunistic infections, and/or clinic infrastructure. Antiretroviral drugs comprised an average of one third of the cost of treatment in South Africa and one half to three quarters of the cost in other countries. Conclusions: There is very little empirical information available about the cost of providing antiretroviral therapy in non-research settings in Africa. Methods for estimating costs are inconsistent, and many estimates combine data drawn from disparate sources. Cost analysis should become a routine part of operational research on the treatment rollout in Africa.

Accelerating Internet Streaming Media Delivery Using Network-Aware Partial Caching

Internet streaming applications are adversely affected by network conditions such as high packet loss rates and long delays. This paper aims at mitigating such effects by leveraging the availability of client-side caching proxies. We present a novel caching architecture (and associated cache management algorithms) that turn edge caches into accelerators of streaming media delivery. A salient feature of our caching algorithms is that they allow partial caching of streaming media objects and joint delivery of content from caches and origin servers. The caching algorithms we propose are both network-aware and stream-aware; they take into account the popularity of streaming media objects, their bit-rate requirements, and the available bandwidth between clients and servers. Using realistic models of Internet bandwidth (derived from proxy cache logs and measured over real Internet paths), we have conducted extensive simulations to evaluate the performance of various cache management alternatives. Our experiments demonstrate that network-aware caching algorithms can significantly reduce service delay and improve overall stream quality. Also, our experiments show that partial caching is particularly effective when bandwidth variability is not very high.

Scalability of Multicast Delivery for Non-sequential Streaming Access

To serve asynchronous requests using multicast, two categories of techniques, stream merging and periodic broadcasting have been proposed. For sequential streaming access where requests are uninterrupted from the beginning to the end of an object, these techniques are highly scalable: the required server bandwidth for stream merging grows logarithmically as request arrival rate, and the required server bandwidth for periodic broadcasting varies logarithmically as the inverse of start-up delay. However, sequential access is inappropriate to model partial requests and client interactivity observed in various streaming access workloads. This paper analytically and experimentally studies the scalability of multicast delivery under a non-sequential access model where requests start at random points in the object. We show that the required server bandwidth for any protocols providing immediate service grows at least as the square root of request arrival rate, and the required server bandwidth for any protocols providing delayed service grows linearly with the inverse of start-up delay. We also investigate the impact of limited client receiving bandwidth on scalability. We optimize practical protocols which provide immediate service to non-sequential requests. The protocols utilize limited client receiving bandwidth, and they are near-optimal in that the required server bandwidth is very close to its lower bound.

A Two-Tiered On-Line Server-Side Bandwidth Reservation Framework for the Real-Time Delivery of Multiple Video Streams

The advent of virtualization and cloud computing technologies necessitates the development of effective mechanisms for the estimation and reservation of resources needed by content providers to deliver large numbers of video-on-demand (VOD) streams through the cloud. Unfortunately, capacity planning for the QoS-constrained delivery of a large number of VOD streams is inherently difficult as VBR encoding schemes exhibit significant bandwidth variability. In this paper, we present a novel resource management scheme to make such allocation decisions using a mixture of per-stream reservations and an aggregate reservation, shared across all streams to accommodate peak demands. The shared reservation provides capacity slack that enables statistical multiplexing of peak rates, while assuring analytically bounded frame-drop probabilities, which can be adjusted by trading off buffer space (and consequently delay) and bandwidth. Our two-tiered bandwidth allocation scheme enables the delivery of any set of streams with less bandwidth (or equivalently with higher link utilization) than state-of-the-art deterministic smoothing approaches. The algorithm underlying our proposed frame-work uses three per-stream parameters and is linear in the number of servers, making it particularly well suited for use in an on-line setting. We present results from extensive trace-driven simulations, which confirm the efficiency of our scheme especially for small buffer sizes and delay bounds, and which underscore the significant realizable bandwidth savings, typically yielding losses that are an order of magnitude or more below our analytically derived bounds.

Service Provisioning in Mobile Networks Through Distributed Coordinated Resource Management

The pervasiveness of personal computing platforms offers an unprecedented opportunity to deploy large-scale services that are distributed over wide physical spaces. Two major challenges face the deployment of such services: the often resource-limited nature of these platforms, and the necessity of preserving the autonomy of the owner of these devices. These challenges preclude using centralized control and preclude considering services that are subject to performance guarantees. To that end, this thesis advances a number of new distributed resource management techniques that are shown to be effective in such settings, focusing on two application domains: distributed Field Monitoring Applications (FMAs), and Message Delivery Applications (MDAs). In the context of FMA, this thesis presents two techniques that are well-suited to the fairly limited storage and power resources of autonomously mobile sensor nodes. The first technique relies on amorphous placement of sensory data through the use of novel storage management and sample diffusion techniques. The second approach relies on an information-theoretic framework to optimize local resource management decisions. Both approaches are proactive in that they aim to provide nodes with a view of the monitored field that reflects the characteristics of queries over that field, enabling them to handle more queries locally, and thus reduce communication overheads. Then, this thesis recognizes node mobility as a resource to be leveraged, and in that respect proposes novel mobility coordination techniques for FMAs and MDAs. Assuming that node mobility is governed by a spatio-temporal schedule featuring some slack, this thesis presents novel algorithms of various computational complexities to orchestrate the use of this slack to improve the performance of supported applications. The findings in this thesis, which are supported by analysis and extensive simulations, highlight the importance of two general design principles for distributed systems. First, a-priori knowledge (e.g., about the target phenomena of FMAs and/or the workload of either FMAs or DMAs) could be used effectively for local resource management. Second, judicious leverage and coordination of node mobility could lead to significant performance gains for distributed applications deployed over resource-impoverished infrastructures.

Differentiated Predictive Fair Service for TCP Flows

The majority of the traffic (bytes) flowing over the Internet today have been attributed to the Transmission Control Protocol (TCP). This strong presence of TCP has recently spurred further investigations into its congestion avoidance mechanism and its effect on the performance of short and long data transfers. At the same time, the rising interest in enhancing Internet services while keeping the implementation cost low has led to several service-differentiation proposals. In such service-differentiation architectures, much of the complexity is placed only in access routers, which classify and mark packets from different flows. Core routers can then allocate enough resources to each class of packets so as to satisfy delivery requirements, such as predictable (consistent) and fair service. In this paper, we investigate the interaction among short and long TCP flows, and how TCP service can be improved by employing a low-cost service-differentiation scheme. Through control-theoretic arguments and extensive simulations, we show the utility of isolating TCP flows into two classes based on their lifetime/size, namely one class of short flows and another of long flows. With such class-based isolation, short and long TCP flows have separate service queues at routers. This protects each class of flows from the other as they possess different characteristics, such as burstiness of arrivals/departures and congestion/sending window dynamics. We show the benefits of isolation, in terms of better predictability and fairness, over traditional shared queueing systems with both tail-drop and Random-Early-Drop (RED) packet dropping policies. The proposed class-based isolation of TCP flows has several advantages: (1) the implementation cost is low since it only requires core routers to maintain per-class (rather than per-flow) state; (2) it promises to be an effective traffic engineering tool for improved predictability and fairness for both short and long TCP flows; and (3) stringent delay requirements of short interactive transfers can be met by increasing the amount of resources allocated to the class of short flows.