the first decade of antiretroviral therapy in africa在非洲的第一个十年的抗逆转录病毒治疗.pdf

Ford et al. Globalization and Health 2011, 7:33 /content/7/1/33 COMMENTARY Open Access The first decade of antiretroviral therapy in Africa Nathan Ford1,2*, Alexandra Calmy3 and Edward J Mills4 Abstract The past decade has seen remarkable progress in increasing access to antiretroviral therapy in resource-limited settings. Early concerns about the cost and complexity of treatment were overcome thanks to the efforts of a global coalition of health providers, activists, academics, and people living with HIV/AIDS, who argued that every effort must be made to ensure access to essential care when millions of lives depended on it. The high cost of treatment was reduced through advocacy to promote access to generic drugs; care provision was simplified through a public health approach to treatment provision; the lack of human resources was overcome through task-shifting to support the provision of care by non-physicians; and access was expanded through the development of models of care that could work at the primary care level. The challenge for the next decade is to further increase access to treatment and support sustained care for those on treatment, while at the same time ensuring that the package of care is continuously improved such that all patients can benefit from the latest improvements in drug development, clinical science, and public health. Introduction Global advocacy to reduce the cost of treatment Since 2001, the international effort to scale up antiretro- The early reluctance to support ART for developing viral therapy (ART) in the developing world has been one countries was driven by both public health caution and of the most important programmes in global health [1]. treatment cost. The fact