HIV This Week

Ojikutu B, Makadzange AT, Gaolathe T. Scaling Up ART Treatment Capacity: Lessons Learned from South Africa, Zimbabwe, and Botswana. Curr HIV/AIDS Rep. 2008;5(2):94-8.

Over the past 3 years, significant strides have been made in the effort to provide antiretroviral therapy to the millions of people worldwide who require treatment for HIV. In 2006, 1.3 million people had initiated antiretroviral therapy in sub-Saharan Africa, which is a 10-fold increase over the number who had access to treatment 3 years prior. Although this progress should be acknowledged, achieving universal access will require much more work. As countries initiate large-scale treatment programmes, many political, social, economic, and operational challenges have become evident. South Africa, Zimbabwe, and Botswana are three neighbouring countries engaged in antiretroviral therapy roll-out. This article describes the HIV epidemic in these three countries, details the most critical challenges inhibiting the progression of antiretroviral therapy roll-out, and highlights successes within each setting.

Editors’ note: This interesting comparative analysis of these three neighbours reveals that although political will and economic stability are predictors of success, weak health care infrastructure and lack of integration of HIV care with primary health care pose challenges to sustained antiretroviral treatment programmes.