在撒哈拉以南非洲地区,在HAART之前的HIV预防
Elliot Marseille1, Paul B Hofmann, James G Kahn
1Institute for Health Policy Studies, Center for AIDS Prevention Studies, and AIDS Research Institute, University of California, San Francisco, Box 0936, San Francisco CA 94143, USA. emarseille@attbi.com
Lancet (London, England)
|June 5, 2002
概括
在撒哈拉以南非洲,优先考虑艾滋病毒预防而不是治疗,最大限度地提高健康效益并挽救生命. 投资预防计划比资助高活性抗逆转录病毒疗法 (HAART) 更具成本效益.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 卫生经济学 卫生经济学
背景情况:
- 撒哈拉以南非洲地区的艾滋病毒/艾滋病大流行需要每年大量资金,估计为92亿美元.
- 目前对联合国全球基金的资金承诺远远低于所需的数额.
- 在预防艾滋病毒和高活性抗逆转录病毒疗法 (HAART) 之间平衡资金是一个关键的挑战.
研究的目的:
- 分析艾滋病毒预防与撒哈拉以南非洲的HAART的成本效益.
- 为了证明资金分配对死亡率的影响.
- 推最佳的资源配置,以最大限度地提高艾滋病毒控制的健康益处.
主要方法:
- 对艾滋病毒预防策略和HAART进行了比较性成本效益分析.
- 模拟不同融资场景对获得的生命年数的影响.
- 审查当前的艾滋病毒/艾滋病资金水平和要求.
主要成果:
- 预防艾滋病毒的成本效益至少是HAART的28倍.
- 以预防为代价,为HAART分配资金会导致更大的生命损失.
- 目前的资金不足,仅有1960亿美元的承诺,而每年920亿美元的需求.
结论:
- 未来在撒哈拉以南非洲地区增加艾滋病毒资金应优先考虑预防和非HAART护理.
- 应该将HAART资金留给示范项目,直到实现广泛的人口预防覆盖.
- 为了有效应对艾滋病毒,实现920亿美元的年度支出目标至关重要.
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