"The analysis is robust," said Dr. Chigwedere. "We used a transparent and accessible calculation, publicly available data, and, where we made assumptions, we explained their basis. We purposely chose very conservative assumptions and performed sensitivity analyses to test whether the results would qualitatively change if a different assumption were used."
In conclusion, the authors write: "Access to appropriate public health practice is often determined by a small number of political leaders. In the case of South Africa, many lives were lost because of a failure to accept the use of available ARVs to prevent and treat HIV/AIDS in a timely manner."
"Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa," JAIDS, online October 16, 2008. Print publication expected December 1, 2008. Pride Chigwedere, MD, George R. Seage III, ScD, MPH, Sofia Gruskin, JD, MIA, Tun-Hou Lee, ScD, and M. Essex, DVM, PhD.
Calculation of Person-Years Lost/AIDS Patients
The authors first estimated the number of persons who were eligible to receive ARV treatment by obtaining the number of deaths from AIDS in South Africa for the period 2000? from UNAIDS. Patients with AIDS who died without getting treatment lost the entire average benefit of ARV therapy. Data regarding individuals who received ARV therapy in South Africa between 2000 and 2005 were obtained from the UNAIDS and WHO ''3 by 5'' records (23% in 2005, less than 10% in 2004, 3% in 2003, and less than 3% for preceding years). The authors propose that South Africa could have started an ARV treatment program in 2000, covering not more than 5% of persons who needed therapy but ramping up t
|Contact: Christina Roache|
Harvard School of Public Health