How Much Does It Cost to Provide Antiretroviral Therapy for HIV/AIDS in Africa?

Background: Many African countries are rapidly expanding HIV/AIDS treatment programs. Empirical information on the cost of delivering antiretroviral therapy (ART) for HIV/AIDS is needed for program planning and budgeting. Methods: We searched published and gray sources for estimates of the cost of providing ART in service delivery (non-research) settings in sub-Saharan Africa. Estimates were included if they were based on primary local data for input prices. Results: 17 eligible cost estimates were found. Of these, 10 were from South Africa. The cost per patient per year ranged from $396 to$2,761. It averaged approximately $850/patient/year in countries outside South Africa and$1,700/patient/year in South Africa. The most recent estimates for South Africa averaged $1,200/patient/year. Specific cost items included in the average cost per patient per year varied, making comparison across studies problematic. All estimates included the cost of antiretroviral drugs and laboratory tests, but many excluded the cost of inpatient care, treatment of opportunistic infections, and/or clinic infrastructure. Antiretroviral drugs comprised an average of one third of the cost of treatment in South Africa and one half to three quarters of the cost in other countries. Conclusions: There is very little empirical information available about the cost of providing antiretroviral therapy in non-research settings in Africa. Methods for estimating costs are inconsistent, and many estimates combine data drawn from disparate sources. Cost analysis should become a routine part of operational research on the treatment rollout in Africa

Negotiating Difference

Lawrence Rosen’s commentary focuses on the legal aspect of Native American sovereignty throughout U.S. history, focusing on ramifications of the recent rise of casino gambling on Indian lands

Do food regulatory systems protect public health?

The purpose of this commentary is to consider the extent to which food regulatory systems protect public health, and how a better job could be done. There are fundamental questions about the role of food regulations in responding to changes in food systems and to food-related public health issues. What is meant by the objective &lsquo;to protect public health and safety&rsquo; in the context of food regulation? Are current systems well balanced between promoting trade and protecting health? What is the role of nutrition in food regulation? Should food regulation be used to promote as well as to protect public health? Should laws and regulations be used to intervene in the formulation and marketing of foods, or should &lsquo;the market&rsquo; merely provide more choices and information for shoppers and consumers to select healthy diets?<br /

The Interjurisdictional Effects of Growth Controls on Housing Prices

No abstract provided.Economic