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Expanding Access to Antiretroviral Therapy in Sub-Saharan Africa: Avoiding the Pitfalls and Dangers, Capitalizing on the Opportunities

David McCoy, DrPH, BMed, Mickey Chopra, MSc, BMed, Rene Loewenson, PhD, Jean-Marion Aitken, MA, Thabale Ngulube, PhD, MBChB, Adamson Muula, MPH, MBBS, Sunanda Ray, MPH, MBBS, Tendayi Kureyi, MPhil, Petrida Ijumba, MPH and Mike Rowson, MSc

Petrida Ijumba is with the Health Systems Trust, Durban, South Africa. Mickey Chopra is with the University of Western Cape School of Public Health, Cape Town, South Africa. Rene Loewenson is with the Training and Research Support Centre, Harare, Zimbabwe. Thabale Ngulube is with the Centre for Health, Science & Social Research, Lusaka, Zambia. Adamson Muula is with the University of Malawi, Lilongwe. Sunanda Ray and Tendayi Kureyi are with the Southern Africa AIDS Network in Harare, Zimbabwe. Mike Rowson is with Medact, London, United Kingdom. At the time of writing, David McCoy was with the Health Systems Trust, Durban South Africa; Sunanda Ray was with the Southern Africa AIDS network, Harare, Zimbabwe, and Jean-Marion Aitken was an independent consultant in Lilongwe, Malawi.



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  		FIGURE 1—— The virtuous and vicious cycles of rapid ART expansion.

Note. ART = antiretroviral therapy; PHC = primary health care.

 




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