No-cost antiretroviral drugs have significantly decreased HIV/AIDS-related deaths in rural areas of Malawi, according to a study recently published in the journal Lancet, Health-e reports. Researchers from the London School of Hygiene and Tropical Medicine examined mortality rates in a population of 32,000 people in northern Malawi between August 2002 and February 2006. An HIV/AIDS clinic opened in the area in June 2005. The researchers found that overall adult mortality rates declined by 10% eight months after the clinic opened. Mortality also decreased by 35% among adults living near the area's only main road, where deaths were highest before the clinic opened (Health-e, 5/9).

Researcher Judith Glynn said, "I think people didn't expect to see an effect that quickly," adding, "Previous clinical studies have shown improved survival, but we have now shown this translates into a clearly measurable effect, even in a rural area, and surprisingly early."

Mattias Egger and Andrew Boulle of the University of Cape Town, who were not involved in the study, said the rapid results seen with the clinic are a result of the fact that the sickest people received antiretrovirals first. They added that less-ill patients would experience fewer benefits as treatment continued. In addition, differences in mortality reductions between people near and far away from the main road show the potential for disparities in treatment access, they said.

About 59% of deaths among people between ages 15 and 59 are attributed to HIV/AIDS in Malawi. However, it has been one of the more successful countries in terms of providing no-cost treatment to HIV-positive people, according to Reuters. Since 2004, Malawi has been able to offer access to no-cost antiretrovirals with funding from the Global Fund To Fight, AIDS, Tuberculosis and Malaria (Hirschler, Reuters, 5/8). According to Health-e, access to antiretrovirals continues to grow throughout Malawi, which researchers believe will result in continued decreasing mortality rates (Health-e, 5/9).

The study is available online.

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