Moise Desvarieux ^1*, Roland Landman ², Bernard Liautaud ³, Pierre-Marie Girard ⁴

¹ University of Minnesota
² Hopital Bichat-Claude Bernard
³ Centre Hospitalo Universitaire de Fort-de-France
⁴ Universite de Paris, Faculte de Medecine Saint-Antoine

^* To whom correspondence should be addressed. E-mail: md108{at}columbia.edu.

	Abstract

The landscape for antiretroviral (ARV) therapy in resource-poor settings has recently changed considerably with the availability of generic drugs, the drastic price reduction of brand drugs, and the simplification of treatment. However, such cost reductions, while allowing the implementation of large-scale donor programmes, have yet to render treatment accessible and possible in the general population. Addressing the problem of HIV treatment in high prevalence/high caseload countries may require that we redefine the problem as a public health mass therapy programme rather than a multiplication of clinical situations. The public health goal cannot simply be the reduction of morbidity and mortality for those treated, but must be the reduction in morbidity and mortality for the many, i.e. at a population level.

Key Words: Epidemiology, Ethics, Global Health, Health Policy, HIV/AIDS, Human Rights

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