4.6 Article

Evidence for scaling up HIV treatment in sub-Saharan Africa: A call for incorporating health system constraints

期刊

PLOS MEDICINE
卷 14, 期 2, 页码 -

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PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pmed.1002240

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资金

  1. UNAIDS through the project Optimal Resource allocation and long-term financing in the HIV sector in the ESA region.
  2. JACH also received funding through Netherlands Organization for Scientific Research (NWO) Talent Scheme Veni
  3. Netherlands Organization for Scientific Research (NWO) Talent Scheme Vici
  4. USAID South Africa
  5. HIV Modelling Consortium
  6. World Health Organization
  7. Medical Research Council [MR/K010174/1B] Funding Source: researchfish

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The ever-growing HIV treatment programs in sub-Saharan Africa (SSA) present local policy makers with complex decision dilemmas, as international guidelines emphasize the need for expanded access to antiretroviral therapy (ART), yet funding has flatlined. We argue that the current evidence base for prioritizing ART scale-up strategies results in recommendations that are theoretically optimal but practically infeasible to implement. Cost-effectiveness analyses (CEAs) of scaling up ART in SSA should be made more responsive to the needs of policy makers by taking into account the local health system. We provide suggestions for a better integration of health system constraints into CEA by integrating supply-and demand-side constraints in mathematical models and improving the dialogue between researchers and policy makers.

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