Effects of antiretroviral therapy (ART) program design on the HIV epidemic in sub-Saharan Africa

Access to antiretroviral therapy (ART) for HIV infection has dramatically increased in recent years. More than eight million people worldwide are now being treated, the majority of whom reside in sub-Saharan Africa. The success of ART roll-out has been possible through large increases in funding, but has been facilitated by the promotion of the “public health approach” to implementing ART in resource-limited settings. The public health approach is characterized by simplified drug formularies and standardized treatment monitoring, which does not insist on laboratory tests that are commonly used for ART management in industrialized countries.

In regions of the world where ART became widely available in the mid 1990s, such as British Columbia, ART expansion was associated with dramatic declines in HIV-related mortality and HIV transmission. However, the population-level impact of ART programs in Sub-Saharan Africa remains to be seen. Dr. David Moore’s program of research will examine how health policies regarding the design and implementation ART treatment programs in Uganda, a low-income country with a generalized HIV epidemic can potentially affect the future shape of the epidemic there.