Optimizing HIV Care in Less Developed Countries

优化欠发达国家的艾滋病毒护理

• 批准号: 7125624
• 负责人: Kenneth Alan Freedberg
• 金额: $ 45.35万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7125624
• 关键词: AIDS therapy; Africa; HIV infections; India; clinical research; communicable disease control; cost effectiveness; geographic difference; health care cost /financing; health care model; health care policy; health services research tag; history of life science; human data; human therapy evaluation; medically underserved population; model design /development; opportunistic infections; patient care management; quality of life; tuberculosis

DESCRIPTION (provided by applicant): Advances in the treatment of HIV disease have produced dramatic reductions in AIDS-related morbidity and mortality in the United States and Europe. However, despite lower drug prices and an increased focus on the global HIV epidemic, severe resource constraints in Africa, Asia and less developed countries throughout the world have limited the availability of antiretroviral therapy and opportunistic infection prophylaxis. With a distinguished track record of analysis and policy impact in the United States and Europe, we propose to build on over 10 years of experience examining the clinical impact, cost and cost-effectiveness of alternative HIV care strategies and expand efforts to three less developed countries. We propose the following aims: 1. To develop the Global AIDS Policy Model, a comprehensive and flexible state-transition model of the natural history and treatment of HIV disease in less developed countries. 2. To analyze data on HIV natural history, treatment efficacy, costs, and quality of life in each of 3 countries: Cote d'Ivoire, India, and South Africa. 3. To assess the clinical impact, cost, and cost-effectiveness of different strategies for antiretroviral therapy, opportunistic infection prophylaxis, and tuberculosis preventive therapy. In accordance with key areas of NIAID interest, these aims will help to develop practical and affordable methods for HIV treatment and inform the rational use of therapy in resource-diverse settings. The products of this proposal will investigate pressing HIV clinical and policy questions in each of these countries, and results will be provided to clinicians delivering care and to health officials responsible for shaping policy. Having already influenced HIV policy in the US through model-based cost-effectiveness analysis, the Global AIDS Policy Model team will formally address resource limitations for HIV care in these representative less developed countries. This project will elucidate questions of optimal HIV management for clinicians, public health officials, and policy makers, and it will provide a durable tool with which to address crucial questions in these countries and in other settings worldwide.

描述（由申请人提供）：在美国和欧洲，艾滋病毒疾病治疗的进步已使艾滋病相关发病率和死亡率大幅下降。然而，尽管药品价格下降，全球艾滋病毒流行日益受到关注，但非洲、亚洲和世界各地欠发达国家的严重资源限制限制了抗逆转录病毒治疗和机会性感染预防的可用性。凭借在美国和欧洲的分析和政策影响方面的杰出记录，我们建议以 10 多年检查替代性艾滋病毒护理策略的临床影响、成本和成本效益的经验为基础，并将努力扩展到三个欠发达国家。我们提出以下目标： 1. 制定全球艾滋病政策模型，这是一个关于欠发达国家艾滋病毒自然史和治疗的全面、灵活的国家转型模型。 2. 分析科特迪瓦、印度和南非这三个国家的艾滋病毒自然史、治疗效果、费用和生活质量的数据。 3. 评估抗逆转录病毒治疗、机会性感染预防和结核病预防治疗的不同策略的临床影响、成本和成本效益。 根据 NIAID 感兴趣的关键领域，这些目标将有助于开发实用且负担得起的艾滋病毒治疗方法，并为在资源多样化的环境中合理使用治疗提供信息。该提案的产品将调查这些国家紧迫的艾滋病毒临床和政策问题，结果将提供给提供护理的临床医生和负责制定政策的卫生官员。 全球艾滋病政策模型团队已经通过基于模型的成本效益分析影响了美国的艾滋病毒政策，他们将正式解决这些代表性欠发达国家的艾滋病毒护理资源限制问题。该项目将为临床医生、公共卫生官员和政策制定者阐明最佳艾滋病毒管理问题，并将提供一个持久的工具来解决这些国家和世界其他地区的关键问题。