PEPFAR Helped Prevent More Than One Million AIDS-Related Deaths in Africa, Study Says
April 7, 2009
The President's Emergency Plan for AIDS Relief has helped prevent more than one million AIDS-related deaths and reduced AIDS-related mortality by an average of 10.5% annually in 12 African focus countries as more people gained access to antiretroviral drugs, according to a study published online Tuesday in the Annals of Internal Medicine, Bloomberg reports. According to the study, the program did not have any effect on overall HIV prevalence. The Agency for Healthcare Research and Quality provided funding for the study.
According to Bendavid, the study demonstrates that PEPFAR has allocated "a lot on treatment and treatment has worked" (Bloomberg, 4/6). Mark Dybul, former U.S. Global AIDS Coordinator and PEPFAR administrator, said that it is "great news that even in the first three years [of PEPFAR], the American people supported the saving of more than a million lives" (Dinan, Washington Times, 4/7). Peter Piot, former executive director of UNAIDS, added that the program "is changing the course of the AIDS epidemic." Piot said, "People are not dying. That is spectacular." However, he added, "The irony -- and it is a positive irony -- is that the more people are staying alive, the higher the percentage" of people living with HIV will be. According to Bendavid, any increase in HIV prevalence "probably reflects the decreasing death rate and may have several public health spillover benefits." For example, HIV-positive adults who live longer lives "may be able to support their children and dependent elderly family members, reducing the burden of orphans and elderly care" (Bloomberg, 4/6).
Despite the study's promising findings, challenges remain for reducing HIV/AIDS prevalence in high-burden countries, the researchers said. For example, as increased treatment distribution allows more HIV-positive people to live longer, the cost of providing treatment to the affected population will increase. According to the study authors, "The gap between the available funds and those needed will continue to increase unless the incidence of HIV in Africa is substantially reduced" by "striking the right balance between treatment and prevention."
According to the authors, about 20% of PEPFAR funding was allocated to prevention under the Bush administration, with about one-third earmarked for abstinence-only efforts (Reuters, 4/6). When Congress reauthorized the program in 2008, the abstinence provision was removed. Bendavid said that the challenge will be to make prevention a "serious component of the program in the next five years" (Bloomberg, 4/6). Smita Baruah, government relations director for the Global Health Council, said that although PEPFAR initially focused on treatment, it should now expand its focus to prevention. She said, "As you move from emergency to sustainability, it's not going to work just to treat your way out of the infection. You now need to figure out how do we prevent new infections" (Washington Times, 4/7). According to Bendavid, "You need to reduce the number of new people infected by at least as many as the number of people you're keeping alive" (Bloomberg, 4/6).
The study is available online.
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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
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