The southern African country introduced free antiretroviral therapy from 2004, thanks to help from the Global Fund for Aids, Tuberculosis and Malaria, and by 2006 the drugs were reaching more than 80 000 patients.

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Doctors from the London School of Hygiene and Tropical Medicine and Malawi's Karonga Prevention Study carried out an investigation among 32 000 people in the rural northern district of Karonga to gauge the impact on Aids mortality after a free drugs clinic opened there in June 2005.

Eight months after its opening, the clinic was treating 107 patients out of an estimated 334 who were in urgent need of the drugs.

Death rate fell by 10%
The overall death rate among local adults aged 15-59, the most exposed group to Aids, fell by 10 percent compared with the three years before the clinic opened. In absolute terms, this translates into nine lives saved.

The authors noted, for instance, the key role of transport in helping rural patients. The decline in mortality in Karonga was most dramatic – 35 percent – among people who lived close to a main highway that bisects the area and who thus had easier access to the clinic.

In remote areas, though, the death rate actually went up. Around one in seven of the adult population in Malawi has HIV, a figure that has remained roughly stable since the late 1990s, according to figures cited in the study.

Around 33 million people around the world are infected with the human immunodeficiency virus (HIV) that causes Aids, according to the agency UNAIDS.

Two thirds of them are living in sub-Saharan Africa, where many countries, especially in the south, were hit by a long delay in securing a fall in the price of antiretroviral drugs that were rolled out in the West in the mid-1990s. – (Sapa)

May 2008

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