Twenty Years Of Antiretroviral Therapy For People Living With HIV: Global Costs, Health Achievements, Economic Benefits

TLDR

Since the introduction of azidothymidine in 1987, antiretroviral therapy has markedly improved global health, yet 15.2 million people with HIV remain untreated, representing a significant lost opportunity. ART averted 9.5 million deaths and generated $1.05 trillion in economic benefits between 1995‑2015, and for every $1 spent, $3.50 in benefits accrued; scaling up to the 90‑90‑90 targets could avert 34.9 million deaths and 40.2 million infections by 2030, raising economic gains to $4.02 trillion, while providing ART to 19.5 million people already marks a major human achievement.

Abstract

Since the introduction of azidothymidine in 1987, significant improvements in treatment for people living with HIV have yielded substantial improvements in global health as a result of the unique benefits of antiretroviral therapy (ART). ART averted 9.5 million deaths worldwide in 1995-2015, with global economic benefits of $1.05 trillion. For every $1 spent on ART, $3.50 in benefits accrued globally. If treatment scale-up achieves the global 90-90-90 targets of the Joint United Nations Programme on HIV/AIDS, a total of 34.9 million deaths are projected to be averted between 1995 and 2030. Approximately 40.2 million new HIV infections could also be averted by ART, and economic gains could reach $4.02 trillion in 2030. Having provided ART to 19.5 million people represents a major human achievement. However, 15.2 million infected people are currently not receiving treatment, which represents a significant lost opportunity. Further treatment scale-up could yield even greater health and economic benefits.