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Expanding access to antiretroviral therapy in sub-Saharan Africa: Avoiding the pitfalls and dangers, capitalizing on the opportunities

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Listed:
  • McCoy, D.
  • Chopra, M.
  • Loewenson, R.
  • Aitken, J.-M.
  • Ngulube, T.
  • Muula, A.
  • Ray, S.
  • Kureyi, T.
  • Ijumba, P.
  • Rowson, M.

Abstract

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.

Suggested Citation

  • McCoy, D. & Chopra, M. & Loewenson, R. & Aitken, J.-M. & Ngulube, T. & Muula, A. & Ray, S. & Kureyi, T. & Ijumba, P. & Rowson, M., 2005. "Expanding access to antiretroviral therapy in sub-Saharan Africa: Avoiding the pitfalls and dangers, capitalizing on the opportunities," American Journal of Public Health, American Public Health Association, vol. 95(1), pages 18-22.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2004.040121_9
    DOI: 10.2105/AJPH.2004.040121
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    Cited by:

    1. McPherson, A., 2009. "Fourniture des services de santĪ˜ et autres interventions de lutte contre le VIH/SIDA dans le secteur halieutique en Afrique sub-saharienne," Monographs, The WorldFish Center, number 38695, April.
    2. Van Damme, Wim & Kober, Katharina & Kegels, Guy, 2008. "Scaling-up antiretroviral treatment in Southern African countries with human resource shortage: How will health systems adapt?," Social Science & Medicine, Elsevier, vol. 66(10), pages 2108-2121, May.
    3. Kerry E Uebel & Gina Joubert & Edwin Wouters & Willie F Mollentze & Dingie H C J van Rensburg, 2013. "Integrating HIV Care into Primary Care Services: Quantifying Progress of an Intervention in South Africa," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-8, January.
    4. McPherson, A., 2009. "Health service delivery and other HIV/AIDS related interventions in the fisheries sector in Sub-Saharan Africa: a literature review," Monographs, The WorldFish Center, number 38688, April.
    5. Kentikelenis, Alexander E., 2017. "Structural adjustment and health: A conceptual framework and evidence on pathways," Social Science & Medicine, Elsevier, vol. 187(C), pages 296-305.

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