South Africa has witnessed an “unparalleled” five-year increase in life expectancy since 2005 thanks to the world’s biggest programme of HIV/Aids drug treatment.
The trend marks a spectacular reversal from when former president Thabo Mbeki was branded an “Aids denialist” whose dogma was blamed for 330,000 deaths. In a few short years, South Africa has gone from global disgrace to shining example.
Professor Salim Abdool Karim, president of the South African Medical Research Council, said the rise in life expectancy – from 54 years in 2005 to 60 in 2011 – was of the order usually only seen after a major societal shift, such as the abolition of slavery.
By making strategic efficiencies in HIV programming, UNAIDS estimates that expansion of treatment can be accelerated within the existing resource needs of between US$ 22-24 billion for 2015. “With smart planning, we estimate that cost savings of around 20% could be made by 2015 which, if invested smartly, would allow us to reach yet more people with lifesaving antiretroviral therapy.”
UNAIDS estimates that cost savings could be achieved through three main areas; a reduction in costs of medicines and medical supplies, particularly as volumes increase; simplifying delivery systems; and increasing efficiencies within the overall AIDS response.
Significant successes in reducing costs have been achieved in recent years. For example the price of medicines to prevent mother to child transmission of HIV was reduced from US$ 800 in 2011 to below US$ 100 in 2013. Through a more competitive bidding process, South Africa has reduced the cost of procurement of antiretrovirals to the lowest price anywhere in the world at US$ 113 per person per year for the fixed dose combination recommended in the new guidelines. This has resulted in a 53% reduction in expenditure on antiretroviral treatment for South Africa.
If the recommendations in the new guidelines are implemented they would avert an estimated 13.5 million deaths and 19 million new HIV infections by 2025.
Can success against cancer, heart disease and Alzheimer’s be achieved on a similar scale and timeline and cost as the success against HIV/Aids ? Can gene therapy, vaccines, new diagnostics impact other major diseases in the same way as success against HIV/Aids ?
Based on per capita income life expectancy in South Africa should be 65 years
In 2005, under Mbeki and health minister Manto Tshabalala-Msimang – who promoted a “treatment” of beets and garlic – only 133,000 patients were on ARVs. Now the total stands at 1.9 million, the biggest programme on the planet.
Aids-related deaths decreased from 257,000 in 2005 to 194,000 in 2010, according to the Actuarial Society of South Africa. The rate at which HIV-positive mothers transmitted the virus to their babies decreased from 8.5% in 2008 to 2.7% in 2011.
A national HIV counselling and testing campaign that was launched two years ago has notched 20m HIV tests in 20 months. South Africa has increased its domestic expenditure on Aids to $1.6bn, the highest by any low- and middle-income country.
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