The large antiretroviral treatment (ART) scale-up in a rural community in KwaZulu-Natal, South Africa, has led to a rapid and dramatic increase in population adult life expectancy—a gain of 11.3 years over eight calendar years (2004-2011)—and the benefit of providing ART far outweighs the cost, according to new research from Harvard School of Public Health (HSPH).

While previous studies have shown that ART significantly improves survival in clinical cohorts of HIV patients receiving ART, this is the first study to directly measure the full population-level impact of a public-sector ART program on adult life expectancy.

“This is one of the most rapid life expectancy gains observed in the history of public health” said Till Bärnighausen, associate professor of global health in the HSPH Department of Global Health and Population and senior author of the study, which was published online in Science on February 21, 2013.

“The public-sector scale-up of ART has largely reversed the decline in adult life expectancy due to HIV that occurred in the 1990s and early 2000s in the region,” said Jacob Bor, the lead author of the study and an HSPH doctoral candidate in the Department of Global Health and Population.

The researchers measured dates of death using data from a large community-based population surveillance system that included information on all births and deaths among more than 100,000 people living in rural KwaZulu-Natal, in South Africa, between 2000 and 2011.

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