Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
South African Press Association - November 3, 2006
It would take 38 years, but deaths would drop by 400 000, the number of those infected with the disease by one million and the incidence of HIV infection by 320 000 -- and the costs associated with the disease would drop by $61-billion.
To achieve this, tests for HIV would have to start at a CD4 count of 350 instead of 200 and thereafter patients should be tested every three months instead of the present six.
Antiretroviral therapy should start at viral loads above 100 000 copies per millilitre. There would be direct costs of $62-billion in increased medical costs, but indirect cost savings would amount to around $123-billion.
"Much of the financial pain would be felt in the first five to 10 years," researcher Dr Peter Mazonson told the international AidsMap organisation on Friday.
The study was developed by Mazonson's Mosaic organisation in collaboration with SA HIV clinical and economic experts including Dr Osman Ebrahim of Brenthurst Clinic in Johannesburg, Dr Ian Sanne of the University of Witwatersrand, Dr Nick Hellman of the Gates Foundation and Dr Gillian Sanders of Duke Clinical Research Institute.
It assessed World Health Organisation (WHO) guidelines for starting antiretroviral therapy against those closer to clinical practice in the United States.
"I guess you would say, on net, there would be a $62-billion short term pain for long term gain," Mazonson said.
The survey is supported by what had happened in other parts of the world.
"This is what effectively happened in the developed world where we've managed to turn this into a chronic illness," he said.
The indirect cost had been calculated by taking SA's per capita gross domestic product multiplied by the difference in potential years of life lost by those who were treated as per the WHO guidelines against those suggested.
"Some people would argue that indirect cost analysis in developing world settings doesn't make sense because so many people are unemployed but by looking at average GDP per capita, we're looking at the average productivity of an employee taking into account those who are employed and those who are unemployed," Mazonson said.
"We think this is important not only in South Africa, but could be extrapolated to other upper middle income countries."
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