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Increasing access to antiretroviral
drugs would drastically cut AIDS deaths in South Africa
Increasing U.S. support could
save more than a million lives by 2012
BOSTON - March 26, 2008 - More that 1.2 million deaths could
be prevented in South Africa over the next five years by accelerating
efforts to provide access to antiretroviral therapy (ART), according
to a study released online today by the Journal of Infectious
Diseases. Using a sophisticated mathematical model of HIV disease
and treatment, a team of researchers led by Rochelle Walensky, MD,
MPH of Massachusetts General Hospital (MGH) estimated the number
of AIDS-related deaths in South Africa through 2012 under alternative
ART scale-up assumptions.
The study results underscore the urgent need for Congress to reauthorize
the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), which
has supported the South African government's effort to increase
access to antiretroviral therapy, the researchers note. "If
ART is not provided to all who need it, HIV mortality will be enormous,"
says Walensky. "Deliberate, purposeful, and expedient scale-up
will save millions of lives in South Africa alone."
South Africa has one of the largest burdens of HIV infection in
the world, with 5 to 6 million individuals and 19 percent of adults
aged 15 to 49 infected. While government programs supported by PEPFAR
and the Global Fund to Fight AIDS, Tuberculosis and Malaria have
steadily increased access to antiretrovirals, at the end of 2006
only a third of individuals eligible for the therapy were receiving
it.
In order to quantify the potential impact of various strategies
for increasing access to ART, the research team projected the number
of deaths under five scenarios - ranging from maintaining current
access levels, through steady and moderate growth levels, to rapid
growth and full access for all patients requiring treatment. Among
other factors, calculations were based on the fact that the one-year
survival rate for eligible patients who receive antiretroviral therapy
is 94 percent, while only 55 percent of those not treated would
be expected to survive one year.
Results showed that maintaining current treatment capacity would
lead to 2.4 million AIDS-related deaths by 2012. Rapid scale-up,
whereby everyone in need would have access by 2011, would reduce
the projected number of deaths to 1.2 million during that time period,
and immediate full access for all eligible patients would drop deaths
to 800,000.
The researchers note that efforts to scale up treatment have resulted
in a fivefold increase in access to ART in low and moderate-income
countries. "Continued investments in antiretroviral treatment
programs worldwide are a public health imperative; the potential
loss of life without such support is simply unacceptable,"
says Walensky, who is an associate professor of Medicine at Harvard
Medical School.
The study was funded by the National Institute of Allergy and Infectious
Diseases and the Doris Duke Charitable Foundation. Study co-authors
are Mariam Fofana, Nomita Divi, Bingxia Wang, and Kenneth Freedberg
of the MGH; Robin Wood, University of Cape Town, South Africa; Milton
Weinstein and Sue Goldie, Harvard School of Public Health; Neil
Martinson, Johns Hopkins University; Elena Losina, Brigham and Women's
Hospital; Yazdan Yazdanpanah, Laboratory of Economic and Social
Research, Lille, France; and A. David Paltiel, Yale University School
of Medicine.
Massachusetts General Hospital, established in 1811, is the original
and largest teaching hospital of Harvard Medical School. The MGH
conducts the largest hospital-based research program in the United
States, with an annual research budget of more than $500 million
and major research centers in AIDS, cardiovascular research, cancer,
computational and integrative biology, cutaneous biology, human
genetics, medical imaging, neurodegenerative disorders, regenerative
medicine, systems biology, transplantation biology and photomedicine.
Media Contacts: Sue
McGreevey, MGH Public Affairs
Physician Referral Service: 1-800-388-4644
Information about Clinical Trials
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