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Which patients first? Setting priorities for antiretroviral therapy where resources are limited

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  • McGough, L.J.
  • Reynolds, S.J.
  • Quinn, T.C.
  • Zenilman, J.M.

Abstract

The availability of limited funds from international agencies for the purchase of antiretroviral (ARV) treatment in developing countries presents challenges, especially in prioritizing who should receive therapy. Public input and the protection of human rights are crucial in making treatment programs equitable and accountable. By examining historical precedents of resource allocation, we aim to provoke and inform debate about current ARV programs. Through a critical review of the published literature, we evaluate 4 precedents for key lessons: the discovery of insulin for diabetes in 1922, the release of penicillin for civilian use in 1943, the development of chronic hemodialysis programs in 1961, and current allocation of liver transplants. We then describe current rationing mechanisms for ARVs.

Suggested Citation

  • McGough, L.J. & Reynolds, S.J. & Quinn, T.C. & Zenilman, J.M., 2005. "Which patients first? Setting priorities for antiretroviral therapy where resources are limited," American Journal of Public Health, American Public Health Association, vol. 95(7), pages 1173-1180.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2004.052738_5
    DOI: 10.2105/AJPH.2004.052738
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    Cited by:

    1. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    2. Sarang Deo & Sameer Mehta & Charles J. Corbett, 2022. "Optimal Scale‐Up of HIV Treatment Programs in Resource‐Limited Settings Under Supply Uncertainty," Production and Operations Management, Production and Operations Management Society, vol. 31(3), pages 883-905, March.
    3. Sofaer, Neema & Kapiriri, Lydia & Atuyambe, Lynn M. & Otolok-Tanga, Erasmus & Norheim, Ole Frithjof, 2009. "Is the selection of patients for anti-retroviral treatment in Uganda fair?: A qualitative study," Health Policy, Elsevier, vol. 91(1), pages 33-42, June.
    4. Cisse, Boubou & Luchini, Stephane & Moatti, Jean Paul, 2007. "Progressivity and horizontal equity in health care finance and delivery: What about Africa?," Health Policy, Elsevier, vol. 80(1), pages 51-68, January.
    5. Friedman, Willa, 2018. "Corruption and averting AIDS deaths," World Development, Elsevier, vol. 110(C), pages 13-25.

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