Improving access to treatment for HIV in sub-Saharan Africa

BMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c6546 (Published 01 December 2010) Cite this as: BMJ 2010;341:c6546
  1. Sergio Bautista-Arredondo, researcher 1,
  2. Veronika J Wirtz, researcher1,
  3. Stefano M Bertozzi, director, HIV and tuberculosis2
  1. 1National Institute of Public Health, Cuernavaca, 62100, Mexico
  2. 2Gates Foundation, Seattle, WA 98102, USA
  1. sbautista{at}insp.mx

Additional funding is important, but using it more efficiently is key

Between 2000 and 2007, funding for HIV and AIDS programmes increased from $2.4bn (£1.5bn; €1.8bn) to $10bn. Antiretroviral drugs are the costliest component of delivering antiretroviral treatment, making up at least half of total treatment costs (excluding programme level costs) in low, lower middle, and upper middle income countries, respectively.1

Previous analyses have noted that in developing countries as coverage of antiretroviral treatment increases the cost falls. Others have focused on factors that influence the cost of antiretrovirals: third party negotiations, volume commitment, the country’s income, costs of active drug ingredients, and product type—generic or innovative.2 3

In the linked study (doi:10.1136/bmj.c6218), Bendavid and colleagues looked at the dramatic fall in the cost of first line antiretroviral drugs that accompanied the equally dramatic rise in foreign assistance between 2003 and 2008 in 13 countries in sub-Saharan Africa.4 Unsurprisingly, they found that both factors were significantly associated with increasing coverage. They also found that the country’s own public health expenditure and a composite World Bank measure of government effectiveness were also positively …

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