The effects of a new clinic offering free antiretroviral (ARV) treatment in northern Malawi could be seen in reduced adult mortality rates even in an area 50 miles away, a new study reports.
In the eight months after the free clinic opened in remote Karonga Town in June 2005, overall adult mortality in the study area fell by 10 percent. Deaths were slashed by 35 percent among adults living near Karonga District's only paved road, a result that highlights possible disparities in treatment access.
In Malawi, HIV/AIDS accounts for 59 percent of deaths among people ages 15-49. However, since 2004 Malawi has been able to provide free ARVs to some patients with support from the Global Fund to Fight AIDS, TB and Malaria.
"I think people didn't expect to see an effect that quickly," said study co-author Judith Glynn of the London School of Hygiene and Tropical Medicine. "Previous clinical studies have shown improved survival but we have now shown this translates into a clearly measurable effect, even in a rural area, and surprisingly early."
The fast improvements reflect the fact that those who were sickest were the first to receive ARVs, said Mattias Egger and Andrew Boulle of the University of Cape Town. As treatment expands to healthier patients, the benefits of treatment may not be as quickly apparent, said the two, who were not involved in the study.
The full report, "Population-Level Effect of HIV on Adult Mortality and Early Evidence of Reversal After Introduction of Antiretroviral Therapy in Malawi," was published in The Lancet (2008;371:1603-1611).
05/08/08
Free AIDS Drugs Slash Death Rate in Malawi Study
Source: Reuters:: Ben Hirschler; Courtesy of the CDC National Center for HIV, STD, and TB Prevention