ARV Treatment: Special Focus
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There is quite considerable consistency in four of the papers included in this "ARV Conference Discussion Area". Three of the papers conclude that ARVs are (a) not affordable in developing countries and (b) not cost-effective in comparison with many other health interventions, with the possible exception of ZDV for HIV+ pregnant women. One of the remaining papers, the case study of the Ivory Coast, argues that when ARVs are provided in a developing country they may reinforce existing inequities in society as a whole, since access for technical and eligibility criteria reasons tends to mean ARV treatment is only available to wealthier people who live in cities. This provides a separate, equity-based argument for governments not to provide ARVs. The fifth paper, by Joe Thomas, is somewhat different, though presumably if some of the trade obstacles discussed were removed the costs of treatment would fall and ARVs could appear far more affordable and cost-effective. However, given the timeframe for achieving any of the results considered desirable in this paper is likely to be fairly long, a key question which the discussion over the next 2 weeks should ideally aim to develop some consensus/ideas on is: Question 1: Given that at present economic analysis indicates that ARVs are unaffordable and unlikely to be cost-effective in developing countries, is economic research on ARVs in developing countries necessary? If so, why, and what kinds of research questions should economists address? A separate but related issue highlighted in the Ivory Coast paper and commented on by John Stover on 21st April <[message]> is that policy-makers do not always make decisions in line with best available evidence/research findings, including those produced by economists. This implies that there may be a role for more policy-focused research, aimed at identifying how it might be possible for economists to improve the likelihood of policy and practice being more consistent with the recommendations arising from their analytical work and research studies. Therefore a key second question which it would be interesting to develop a discussion around is: Question 2: Would policy-analysis focused research in the field of ARV treatment be useful? If so, how could/should this be done? |
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