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U.S. AIDS program saved million African lives: study

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Reuters Health

Monday, April 6, 2009

A Kenyan woman prepares ribbons ahead of December 1st, the World Aids Day at Beacon of Hope centre in Nairobi. Picture taken on November 25, 2004. REUTERS/Antony NjugunaBy Julie Steenhuysen

CHICAGO (Reuters) - A U.S. program launched during the Bush administration has cut AIDS deaths by 10 percent in targeted African nations compared to their neighbors and saved more than a million lives, U.S. researchers said on Monday.

The study tracked AIDS deaths and HIV infections in 12 African countries getting aid under the President's Emergency Plan for AIDS Relief, or PEPFAR, during the four years after it was launched in 2003 as a five-year, $15 billion effort.

The program has made a major impact in saving lives but has done little to reduce the number of people infected with the human immunodeficiency virus, or HIV, which causes AIDS, the researchers found.

"It has averted deaths -- a lot of deaths -- with about a 10 percent reduction compared with neighboring African countries," Dr. Eran Bendavid of Stanford University School of Medicine in California, whose study appears in the journal Annals of Internal Medicine, said in a statement.

"However, we could not see a change in prevalence rates that was associated with PEPFAR," Bendavid said.

Bendavid said the 10 percent decline translates to about 1.1 to 1.2 million deaths that have been prevented.

PEPFAR is the largest U.S. foreign aid program devoted to a single disease and has been lauded as a bright spot of former President George W. Bush's tenure. It pays for drug treatment for people infected with HIV as well as other steps such as prevention efforts.

Last July, the U.S. Congress voted to spend $48 billion to expand PEPFAR for five years to treat and prevent AIDS, tuberculosis and malaria in sub-Saharan Africa and elsewhere. About 33 million people are infected with HIV and 2 million die of AIDS each year, according to the World Health Organization.

PALPABLE EFFECT

Bendavid said in a telephone interview his study is one of the first to look at whether PEPFAR has helped change the course of the AIDS epidemic. It offers concrete evidence that foreign aid programs can bring about positive change, he said.

"It is making a palpable and discernible impact," he said.

The researchers gathered data on 12 countries targeted by the program, and compared this to 29 other African nations. They looked at the five years leading up to the start of the program in 2003, and then from 2004 to 2007 after it began.

The African countries receiving PEPFAR aid that were tracked in the study were: Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia.

PEPFAR initially provided aid in those 12 African countries and three others elsewhere, and has since been expanded.

The researchers found that in the years leading up the start of the program, death rates rose in all of the countries studied. But as PEPFAR funding became available, the death toll declined by more than 10 percent in the focus countries compared to countries not participating in the program.

PEPFAR spent about $2,450 on treatment for each life saved, the study found. "This is not a trivial cost, and PEPFAR will need to make the available resources go a long way to continue changing the course of the epidemic," Bendavid said.

Bendavid said the program is reducing the death toll from HIV, allowing people to work and support their families and local economies. "There has to be a very strong focus on prevention, especially when the number of people infected is still staggeringly high," Bendavid said.

(Editing by Maggie Fox and Will Dunham)


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