ONE WORLD, ONE HOPE - THE COST OF PROVIDING ANTIRETROVIRAL THERAPY TOALL NATIONS

Objective: To estimate the potential direct cost of making triple comb ination antiretroviral therapy widely available to HIV-positive adults and children living in countries throughout the world. Methods: For e ach country, antiretroviral costs were obtained by multiplying the ann ual cost of triple antiretroviral therapy by the estimated number of H IV-positive persons accessing therapy. Per capita antiretroviral costs were computed by dividing the antiretroviral costs by the country's t otal population. The potential economic burden was calculated by divid ing pel capita antiretroviral costs by the gross national product (CNP ) per capita. All values are expressed in 1997 US dollars. Results: Th e potential cost of making triple combination antiretroviral therapy a vailable to HIV-positive individuals throughout the world was estimate d to be over US$ 65.8 billion. By far the greatest financial burden wa s on sub-Saharan Africa. The highest per capita drug cost in this regi on would be incurred in the subregions of Southern Africa (US$ 149) fo llowed by East Africa (US$ 116), Middle Africa (US$ 44), and West Afri ca (US$ 42). In the Americas, subregional data indicated the highest p er capita drug cost would be in the Latin Caribbean (US$ 22), followed by the Caribbean (US$ 17), Andean Area (US$ 7), the Southern Cone (US $ 6), North America (US$ 6), and Central American Isthmus (US$ 5). In Asia and Europe the percentage of the GNP necessary to finance drug th erapy was less than 1% in most countries examined. Conclusion: Our res ults demonstrate that the cost of making combination antiretroviral th erapy available worldwide would be exceedingly high, especially in cou ntries with limited financial resources. (C) 1998 Lippincott Williams & Wilkins