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

Posted by Kimberley Meijers on March 1, 2017 at 5:05 pm



Summary points

  • 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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