Affordability, cost and cost-effectiveness of universal anti-retroviral therapy for HIV

* South African Centre for Epidemiological Modelling and Analysis, Stellenbosch, South Africa † Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland Correspondence to [email protected] Abstract If people at risk of HIV infection are tested annually and started on treatment as soon as they are found to be HIV-positive it should be possible to reduce the case reproduction number for HIV to less than one, eliminate transmission and end the epidemic. If this is to be done it is essential to know if it would be affordable, and cost effective. Here we show that in all but eleven countries of the world it is affordable by those countries, that in these eleven countries it is affordable for the international community, and in all countries it is highly costeffective. Introduction The science behind Treatment-as-Prevention is clear. Annual testing and immediate ART can stop transmission and at the same time gives people infected with HIV the best prognosis. Furthermore, a number of studies have shown that ART is cost-effective even in poorly resourced countries. Here we use data on the number of people living with HIV and the gross domestic product (GDP), for all countries, to explore the affordability, cost and cost-effectiveness of putting all HIV-positive people onto ART.