Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Health Aff (Millwood). 2012 Jul;31(7):1470-7. doi: 10.1377/hlthaff.2012.0217.
Federal expenditures are under scrutiny in the United States, and the merits of continuing and expanding the President's Emergency Plan for AIDS Relief (PEPFAR) to support access to antiretroviral therapy have become a topic of debate. A growing body of research on the economic benefits of treatment with antiretroviral therapy has important implications for these discussions. For example, research conducted since the inception of PEPFAR shows that HIV-infected adults who receive antiretroviral therapy often begin or resume productive work, and that children living in households with infected adults who are on treatment are more likely to attend school than those in households with untreated adults. These benefits should be considered when weighing the overall benefits of providing antiretroviral therapy against its costs, particularly in the context of discussions about the future of PEPFAR. A modest case can also be made in favor of having private companies in HIV-affected countries provide antiretroviral therapy to their employees and dependents, thus sharing some of the burden of funding HIV treatment.
在美国,联邦支出受到审查,继续和扩大总统艾滋病紧急救援计划(PEPFAR)以支持获得抗逆转录病毒治疗的优点已成为辩论的话题。越来越多的关于抗逆转录病毒治疗的经济效益的研究对这些讨论具有重要意义。例如,自 PEPFAR 成立以来进行的研究表明,接受抗逆转录病毒治疗的艾滋病毒感染者成年人经常开始或恢复生产性工作,而与未接受治疗的成年人生活在同一家庭的感染成年人的孩子更有可能上学比那些与未接受治疗的成年人生活在同一家庭的孩子。在权衡提供抗逆转录病毒治疗的整体效益与其成本时,应考虑到这些益处,特别是在讨论 PEPFAR 的未来时。在受艾滋病毒影响的国家,私营公司也可以为其员工及其家属提供抗逆转录病毒治疗,从而分担部分艾滋病毒治疗的资金负担。