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

by Evelinn Mikkelsen, Jan A. C. Hontelez, Maarten P. M. Jansen et al.
PLoS Med 14(2): e1002240 – Published: February 21, 2017

5 pp. 600 kB
http://journals.plos.org/plosmedicine/article/file?
id=10.1371/journal.pmed.1002240&type=printable

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. The authors 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.

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