The study, published in The Lancet shows that the effect is large enough to see at a population level. Malawi suffers around 80 000 deaths each year from AIDS - out of a population of 13 million. Free antiretroviral treatment was started between 2004 and 2008 and offered to over 80 000 patients. This free treatment programme was evaluated by Andreas Jahn and Judith Glynn (London School of Hygiene and Tropical Medicine or LSHTM), and colleagues in Malawi. Mortality measurements were taken from August 2002, before the availability of free antiretrovirals, to February 2006, eight months after the opening of a free antiretroviral clinic in northern Malawi.
Before June 2005, the researchers report, the mortality rate among adults aged 15-59 years was 9.8 per 1000 person-years of observation. The researchers found that the probability of both men and women dying between these ages was about 43% and about 65% of deaths (229 of 352) were related to AIDS. The data collected eight months after the opening of the free antiretroviral clinic indicated that of about 334 who needed treatment, 107 accessed it. Still, there was a 10% reduction in mortality in adults, and a 35% reduction in adults who were near the main road (a location where pre-ART mortality was greatest). When subgrouping by age, the researchers found that mortality rates in adults aged 60 years or more did not change.
Read the full article here http://www.thelancet.com/journals/lancet/article/PIIS0140673608606935/fulltext
