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.

A Minimal GB Parser

We describe a GB parser implemented along the lines of those written by Fong [4] and Dorr [2]. The phrase structure recovery component is an implementation of Tomita's generalized LR parsing algorithm (described in [10]), with recursive control flow (similar to Fong's implementation). The major principles implemented are government, binding, bounding, trace theory, case theory, θ-theory, and barriers. The particular version of GB theory we use is that described by Haegeman [5]. The parser is minimal in the sense that it implements the major principles needed in a GB parser, and has fairly good coverage of linguistically interesting portions of the English language.

Load Profiling for Efficient Route Selection in Multi-Class Networks

High-speed networks, such as ATM networks, are expected to support diverse Quality of Service (QoS) constraints, including real-time QoS guarantees. Real-time QoS is required by many applications such as those that involve voice and video communication. To support such services, routing algorithms that allow applications to reserve the needed bandwidth over a Virtual Circuit (VC) have been proposed. Commonly, these bandwidth-reservation algorithms assign VCs to routes using the least-loaded concept, and thus result in balancing the load over the set of all candidate routes. In this paper, we show that for such reservation-based protocols|which allow for the exclusive use of a preset fraction of a resource's bandwidth for an extended period of time-load balancing is not desirable as it results in resource fragmentation, which adversely affects the likelihood of accepting new reservations. In particular, we show that load-balancing VC routing algorithms are not appropriate when the main objective of the routing protocol is to increase the probability of finding routes that satisfy incoming VC requests, as opposed to equalizing the bandwidth utilization along the various routes. We present an on-line VC routing scheme that is based on the concept of "load profiling", which allows a distribution of "available" bandwidth across a set of candidate routes to match the characteristics of incoming VC QoS requests. We show the effectiveness of our load-profiling approach when compared to traditional load-balancing and load-packing VC routing schemes.

Unicast Routing: Cost-Performance Tradeoffs

The objective of unicast routing is to find a path from a source to a destination. Conventional routing has been used mainly to provide connectivity. It lacks the ability to provide any kind of service guarantees and smart usage of network resources. Improving performance is possible by being aware of both traffic characteristics and current available resources. This paper surveys a range of routing solutions, which can be categorized depending on the degree of the awareness of the algorithm: (1) QoS/Constraint-based routing solutions are aware of traffic requirements of individual connection requests; (2) Traffic-aware routing solutions assume knowledge of the location of communicating ingress-egress pairs and possibly the traffic demands among them; (3) Routing solutions that are both QoS-aware as (1) and traffic-aware as (2); (4) Best-effort solutions are oblivious to both traffic and QoS requirements, but are adaptive only to current resource availability. The best performance can be achieved by having all possible knowledge so that while finding a path for an individual flow, one can make a smart choice among feasible paths to increase the chances of supporting future requests. However, this usually comes at the cost of increased complexity and decreased scalability. In this paper, we discuss such cost-performance tradeoffs by surveying proposed heuristic solutions and hybrid approaches.

Foundational Theory for Understanding Policy Routing Dynamics

In this paper we introduce a theory of policy routing dynamics based on fundamental axioms of routing update mechanisms. We develop a dynamic policy routing model (DPR) that extends the static formalism of the stable paths problem (introduced by Griffin et al.) with discrete synchronous time. DPR captures the propagation of path changes in any dynamic network irrespective of its time-varying topology. We introduce several novel structures such as causation chains, dispute fences and policy digraphs that model different aspects of routing dynamics and provide insight into how these dynamics manifest in a network. We exercise the practicality of the theoretical foundation provided by DPR with two fundamental problems: routing dynamics minimization and policy conflict detection. The dynamics minimization problem utilizes policy digraphs, that capture the dependencies in routing policies irrespective of underlying topology dynamics, to solve a graph optimization problem. This optimization problem explicitly minimizes the number of routing update messages in a dynamic network by optimally changing the path preferences of a minimal subset of nodes. The conflict detection problem, on the other hand, utilizes a theoretical result of DPR where the root cause of a causation cycle (i.e., cycle of routing update messages) can be precisely inferred as either a transient route flap or a dispute wheel (i.e., policy conflict). Using this result we develop SafetyPulse, a token-based distributed algorithm to detect policy conflicts in a dynamic network. SafetyPulse is privacy preserving, computationally efficient, and provably correct.

On the Cost of Supporting Multihoming and Mobility

As the Internet has evolved and grown, an increasing number of nodes (hosts or autonomous systems) have become multihomed, i.e., a node is connected to more than one network. Mobility can be viewed as a special case of multihoming—as a node moves, it unsubscribes from one network and subscribes to another, which is akin to one interface becoming inactive and another active. The current Internet architecture has been facing significant challenges in effectively dealing with multihoming (and consequently mobility). The Recursive INternet Architecture (RINA) [1] was recently proposed as a clean-slate solution to the current problems of the Internet. In this paper, we perform an average-case cost analysis to compare the multihoming / mobility support of RINA, against that of other approaches such as LISP and MobileIP. We also validate our analysis using trace-driven simulation.

A Neural Model of Visually Guided Steering, Obstacle Avoidance, and Route Selection

A neural model is developed to explain how humans can approach a goal object on foot while steering around obstacles to avoid collisions in a cluttered environment. The model uses optic flow from a 3D virtual reality environment to determine the position of objects based on motion discotinuities, and computes heading direction, or the direction of self-motion, from global optic flow. The cortical representation of heading interacts with the representations of a goal and obstacles such that the goal acts as an attractor of heading, while obstacles act as repellers. In addition the model maintains fixation on the goal object by generating smooth pursuit eye movements. Eye rotations can distort the optic flow field, complicating heading perception, and the model uses extraretinal signals to correct for this distortion and accurately represent heading. The model explains how motion processing mechanisms in cortical areas MT, MST, and VIP can be used to guide steering. The model quantitatively simulates human psychophysical data about visually-guided steering, obstacle avoidance, and route selection.

A Neural Model of Visually Guided Steering, Obstacle Avoidance, and Route Selection

A neural model is developed to explain how humans can approach a goal object on foot while steering around obstacles to avoid collisions in a cluttered environment. The model uses optic flow from a 3D virtual reality environment to determine the position of objects based on motion discontinuities, and computes heading direction, or the direction of self-motion, from global optic flow. The cortical representation of heading interacts with the representations of a goal and obstacles such that the goal acts as an attractor of heading, while obstacles act as repellers. In addition the model maintains fixation on the goal object by generating smooth pursuit eye movements. Eye rotations can distort the optic flow field, complicating heading perception, and the model uses extraretinal signals to correct for this distortion and accurately represent heading. The model explains how motion processing mechanisms in cortical areas MT, MST, and posterior parietal cortex can be used to guide steering. The model quantitatively simulates human psychophysical data about visually-guided steering, obstacle avoidance, and route selection.