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Commen Normal No Spacing Heading 1 ~ Editing Dictate Styles IN Voice Health system and macroeconomic costs are substantial. Nigeria must invest in laboratory capacity, reliable ART and diagnostic supply chains, and expanded PMTCT to avert infant infections investments competing with other priorities (PEPFAR Nigeria, 2023). In the United States, the discounted lifetime medical cost of one HIV infection is about $420,000, so preventing new infections yields large savings; preventable outbreaks in areas without harm- reduction services add emergency and public-health costs (CDC, 2023). Across both countries, scaling community-based testing, same-day ART, POSE. P PREP PMTCT, and harm reduction consistently lowers incidence, increases productivity, and reduces premature mortality (CDC, 2028; HRSA, 2023; UNAIDS, 2023)