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Cost-Effective Treatment Possible In Africa For HIV-Positive Pregnant Women If Drug Prices Lowered

duce the costs of counseling and testing pregnant women for HIV without compromising the quality of these services.

In previous studies in the U.S., the AIDS Clinical Trial Group of the National Institutes of Health found treatment with AZT beginning at the 28th week of pregnancy reduced vertical transmission by about two thirds, according to Diane Wara, MD, UCSF professor of pediatrics who has done extensive work in this area.

"While this protocol has great implications for efforts to stem vertical transmission, it is not practical in Sub-Saharan regions because women normally do not seek prenatal care this early in the pregnancy and this long course of therapy is too costly for the limited resources of the region," Marseille said.

According to co-investigator Kahn, the UCSF analysis "demonstrates that the interventions initially tested in the U.S. and other wealthy countries can lead to affordable public health strategies in poorer countries." But several steps must occur, he noted, for this to happen: shorter therapy and other changes to minimize resource use; careful evaluation of treatment efficacy of modified therapies; and reduction of high cost components, which in this case is drug price.

Directed by Thomas J. Coates, PhD, who also is a UCSF professor of medicine, epidemiology and biostatistics, the UCSF ARI is an institute without walls that encompasses all UCSF AIDS programs under a single umbrella. The ARI includes a dozen research institutes, a wide range of clinical, behavioral science, and policy programs, and close to 1,000 investigators.


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Contact: Corinna Kaarlela
corinna@itsa.ucsf.edu
(415) 476-3804
University of California - San Francisco
8-May-1998


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