Comprehensive Response to HIV Prevention and Care Could Avert 10 Million Deaths in Africa by 2020
For immediate release: January 10, 2005
Boston, MA-- A new study published in the January, 2005 issue of PLoS Medicine shows that a combination of wide access to AIDS treatment and strong national prevention activities could avert 10 million deaths in Africa by 2020. Prevention on its own may be much less successful in reducing new infections, while a roll-out of treatment in isolation could actually increase the number of infections in the worst-case scenario, the study shows.
PLoS Medicine, an open-access journal, is available at www.plosmedicine.org
In the first modeling of the long-term effects of treatment and prevention on the HIV epidemic in Africa, Joshua Salomon, Assistant Professor in the Department of Population and International Health at Harvard School of Public Health (HSPH), and colleagues at HSPH, UNAIDS, UNICEF, the Futures Group and the Global Fund to Fight AIDS, Tuberculosis and Malaria, have analyzed the potential impact on new infections and mortality if large-scale treatment is used either alone or combined with scaled-up prevention efforts. The authors have developed a computer simulation model of the HIV epidemic in sub-Saharan Africa, where three-fourths of deaths from AIDS occur. They examined a wide range of scenarios that reflect varying implementations of prevention and treatment.
With no change in current levels of prevention and care, HIV infections and AIDS deaths in Africa are expected to continue rising to reach approximately 4 million new infections and 3 million adult deaths per year by 2020. A combination of treatment and prevention offers the greatest promise to avert these infections and deaths in the near-term and over the coming decades. The authors predict that combining both approaches could reduce projected new infections by 74 percent and projected annual mortality by half. Between now and 2020, these benefits translate into 29 million new infections averted and 10 million deaths averted in total. The combination of prevention and care offers gains that are potentially much greater than simply the sum of the two approaches pursued alone.
Without effective prevention programs, the authors project that the number of people receiving urgent treatment will grow to more than 9 million by 2020 in Africa alone to achieve 80 percent coverage of those in most dire need. Integrating effective prevention programs would bring this number down to around 4 million. "Although dramatic declines in drug costs are bringing treatment within reach even in the poorest settings," notes HSPH's Salomon, "the sustainability of treatment programs demands effective prevention in order to ease the financial burden on strained health care systems as treatment rolls out on a large scale."
Bernhard Schwartländer, study co-author and Director of Strategic Information and Evaluation at the Global Fund, said: "Debate about prevention versus treatment is based on a false dichotomy. There is now a rare opportunity to make the maximum impact by taking advantage of possibilities for treatment and prevention to be mutually reinforcing. We cannot afford to lose this opportunity by failing to devote resources and attention to strengthening both sets of efforts."
"For millions of infected people in urgent need, immediate treatment offers the only hope for survival," said Salomon. "But to save the most lives over the long term, it is absolutely essential to protect people from getting infected in the first place."
The authors write: "Treatment can enable more effective prevention, and prevention makes treatment affordable. Sustained progress in the global fight against HIV/AIDS will be attained only through a comprehensive response."
This study was supported, in part, by a grant from the National Institute on Aging.
For further information contact:
Harvard School of Public Health
Global Fund to Fight AIDS, Tuberculosis and Malaria
Geneva Contact: Jon Liden
(41) 22 791 1723