HIV prevention before HAART in sub-Saharan Africa
HIV prevention before HAART in sub-Saharan Africa
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DOI：
10.1016/s0140-6736(02)08705-6
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发表时间：
2002-05-25
期刊：
影响因子：
168.9
通讯作者：
Kahn, JG
中科院分区：
文献类型：
--
作者：
Marseille, E;Hofmann, PB;Kahn, JG
关于撒哈拉以南非洲预防艾滋病毒的成本效益和关于高效抗逆转录病毒疗法（HAART）的数据表明，预防的成本效益至少是HAART的28倍。我们的目标是表明，以牺牲预防为代价资助高效抗逆转录病毒疗法意味着更大的生命损失。为了最大限度地提高保健效益，撒哈拉以南非洲艾滋病毒供资的下一个主要增量应主要用于预防和一些非haart治疗和护理。应将资金分配给HAART，主要用于示范项目，这些项目将有助于在预防方案广泛覆盖人口之后准备扩大HAART的供应。艾滋病规划署和伦敦卫生和热带医学学院最近估计，每年至少需要92亿美元来对艾滋病毒流行病作出适当反应，包括为HAART提供大量资金。迄今为止，已向新成立的联合国抗击艾滋病、结核病和疟疾全球基金承诺19.6亿美元。从道义上讲，必须毫不拖延地实施扩大的艾滋病毒控制方案，并尽快实现每年支出92亿美元或更多的目标。这项分析的结论和建议涉及在目前资金有所改善但不足的时期分阶段开展更多与艾滋病毒有关的活动。
Data on the cost-effectiveness of HIV prevention in sub-Saharan Africa and on highly active antiretroviral therapy (HAART) indicate that prevention is at least 28 times more cost effective than HAART. We aim to show that funding HAART at the expense of prevention means greater loss of life. To maximise health benefits, the next major increments of HIV funding in sub-Saharan Africa should be devoted mainly to prevention and to some non-HAART treatment and care. Funds should be allocated to HAART primarily for demonstration projects that will help prepare for scaled-up HAART provision following broad population coverage by prevention programmes. UNAIDS and the London School of Hygiene and Tropical Medicine recently estimated that at least US$9.2 billion annually is required to mount an appropriate response to the HIV pandemic, including substantial funding for HAART. To date, US$1.96 billion has been committed to the newly-established UN Global Fund to Fight AIDS, Tuberculosis, and Malaria. It is a moral Imperative that expanded programmes to control HIV be implemented without delay, and that the goal of US$9.2 billion or more in annual spending be attained as rapidly as possible. The findings and recommendations of this analysis pertain to the phasing in of additional HIV-related activities during the current period of improved but inadequate funding.