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January 27, 2015

Maximizing Antiretroviral Therapy in Developing Countries: The Dual Challenge of Efficiency and Quality

Author Affiliations
  • 1Institute for Health Metrics and Evaluation, Seattle, Washington
JAMA. 2015;313(4):359-360. doi:10.1001/jama.2014.16376

The rapid scale-up of antiretroviral therapy (ART) has been one of the great achievements of global health in the last decade. Declines in deaths from human immunodeficiency virus (HIV)/AIDS in high-income countries following the adoption of highly active ART starting in 1996 are well documented. In low-resource settings, demographic surveillance sites have recorded marked decreases in death rates with the scale-up of ART. In its modeling efforts, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that global mortality declined by 35% from 2005 to 2013, with much of the decline related to ART scale-up.1 The Global Burden of Disease (GBD) collaboration recently estimated that 19 million extra years of life have been gained as a result of ART and prevention of mother-to-child transmission of HIV.2