Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa

Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities

Dados Bibliográficos

ID11025931
AutoresDavid Mccoy (0000-0001-7305-8594, Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Mickey Chopra (0000-0003-4020-2937, Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Rene Loewenson (0000-0002-9928-540X, Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Jean-Marion Aitken (Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Thabale J Ngulube (Health Systems Trust), Thabale Ngulube (Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Adamson S Muula (0000-0003-4412-9773, Health Systems Trust), Adamson Muula (Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Sunanda Ray (0000-0002-7214-1596, Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Tendayi Kureyi (Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Petrida Ijumba (Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...), Mike Rowson (Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike...)
Ano2005
Volume95
Fascículo1
Páginas18-22
Data de publicação2005-01-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoAmerican Journal of Public Health (JOURNAL)
Identificadores do periódicoISSN: 0090-0036 • E-ISSN: 1541-0048
EditoraAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2004.040121
PMID15623853
PMCIDPMC1449845
OpenAlexW2128639045
IdiomaEN
Citações recebidas21
Referências citadas12

We describe a number of pitfalls that may occur with the push to rapidly expand access to antiretroviral therapy in sub-Saharan Africa. These include undesirable opportunity costs, the fragmentation of health systems, worsening health care inequities, and poor and unsustained treatment outcomes. On the other hand, AIDS “treatment activism” provides an opportunity to catalyze comprehensive health systems development and reduce health care inequities. However, these positive benefits will only happen if we explicitly set out to achieve them. We call for a greater commitment toward health activism that tackles the broader political and economic constraints to human and health systems development in Africa, as well as toward the resuscitation of inclusive and equitable public health systems

Antiretroviral therapy · Development economics · Economic growth · Economics · Environmental health · Family medicine · Health care · Healthcare system · Human immunodeficiency virus (HIV) · Political science · Politics · Public health · Public relations · Right to health · Set (abstract data type) · Viral load · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Law · Medicine · Nursing · Poverty, Education, and Child Welfare