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Increases in Adult Life Expectancy in Rural South Africa: Valuing the Scale-Up of HIV Treatment

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Science  22 Feb 2013:
Vol. 339, Issue 6122, pp. 961-965
DOI: 10.1126/science.1230413

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Cost-Benefit of ART

In the battle to control HIV, mass antiretroviral treatment (ART) costs $500 to $900 per person per year. Bor et al. (p. 961) calculated the impact of intensifying ART on the life expectancy of people living in rural KwaZulu Natal. The dates of death were collected from a population of about 100,000 people during 2000–2011: Four years before and 8 years after the scaling up of ART. Life expectancy of adults increased by more than 11 years after ART was expanded, and the economic value of the lifetimes gained were calculated to far exceed the cost of treatment. Tanser et al. (p. 966) followed nearly 17,000 HIV-uninfected individuals in KwaZulu-Natal over an 8-year period. Holding other HIV risk factors constant, individual HIV acquisition risk declined significantly with increasing ART coverage of HIV-infected people.