Antiretroviral therapy in resource-poor countries: illusions and realities.
The prospects for antiretroviral therapy in resource-poor settings have changed recently and considerably with the availability of generic drugs, the drastic price reduction of brand-name drugs, and the simplification of treatment. However, such cost reductions, although allowing the implementation of large-scale donor programs, have yet to render treatment accessible and possible in the general population. Successfully providing HIV treatment in high-prevalence/high-caseload countries may require that we redefine the problem as a public health mass therapy program rather than a multiplication of clinical situations. The public health goal cannot simply be the reduction of morbidity and mortality for those treated but must be the reduction in morbidity and mortality for the many, that is, at a population level.
Desvarieux
Moïse
M
Department of Epidemiology, Mailman School of Public Health, 722 W 168th St, New York, NY 10032, USA. md108@columbia.edu
Landman
Roland
R
Liautaud
Bernard
B
Girard
Pierre-Marie
PM
D044966:Anti-Retroviral Agents / Q000191:economics / Q000627:therapeutic use*; D003695:Delivery of Health Care / Q000941:ethics*; D003906:Developing Countries; D016568:Drugs, Generic / Q000191:economics*; D015658:HIV Infections / Q000188:drug therapy*; D006291:Health Policy / Q000191:economics*; D006806:Human Rights; D006801:Humans
D044966:Anti-Retroviral Agents; D016568:Drugs, Generic