ARV Treatment: Special Focus
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ARV Treatment: Special Focus Back to Main Page |
Ralph Frerichs correctly points out that public health interventions
against HIV are likely to offer better value for money to most poorer
countries than antiretroviral treatment for AIDS sufferers. This does not
alter the fact that in many countries, however, there is substantial
private demand for any drugs claiming to cure AIDS, and this manifests as
significant expenditure on various forms of quackery, with which
antiretrovirals probably compare quite favourably in cost effectiveness.
This of course does not alter the fact that the state should probably steer
clear of providing antiretrovirals for treating the AIDS-sick as long as is
politically feasible.
I think that the use of anti-retrovirals for prevention of mother to child
transmission is an entirely different issue, however. First of all, this
intervention is essentially a preventive, rather than "AIDS treatment" one,
so is qualitatively different from use of ARVs for treatment.
Secondly, evidence emerging from South Africa suggests that it is probably
quite cost effective compared to existing child health interventions in the
country.
Prior to cost effectiveness studies, however, there was ageneral feeling
that the costs of perinatal ARVs plus screening and counselling, etc,
costing around 2% of the public health budget, made them unaffordable, and
hence a non-option. This of course ignored the existing expenditure on HIV
sick children, which is significant, and, when traded off against the costs
of ARVs reduced them substantially. I would thus be reluctant to make
decisions solely on so called "affordability" data.
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Dr R Neil Soderlund
Centre for Health Policy
P.O. Box 1038
Johannesburg, 2000
South Africa
Street address : corner De Korte and Hospital Streets
Hillbrow, Johannesburg
Tel +27-11-489-9883
Fax +27-11-489-9900
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