Malawi is a low-income country with an estimated population of 16 million in 2012.
In 2004, approximately 930, 000 Malawians were thought to be infected with human immunodeficiency virus (HIV), with an estimated 100 000 new HIV infections occurring annually and around 170 000 people in immediate need of antiretroviral therapy (ART). That year, the Malawian Ministry of Health decided to scale up ART nationwide.
Before the scale-up, only 9 hospitals in the public sector were delivering ART to about 3000 patients and treatment was unstructured, few health-care workers had received formal training in ART and there were no national systems of monitoring, recording and reporting. This paper discusses the achievements of the scale-up in the face of severe health-system constraints and highlights the lessons learnt and new challenges.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Andreas Jahn, Anthony D Harries, Erik J Schouten, Edwin Libamba, Nathan Ford, Dermot Maherf, Frank Chimbwandira (2016) Scaling-up antiretroviral therapy in Malawi. BulletinWorld Health Organization 2016;94:772–776 doi: http://dx.doi.org/10.2471/BLT.15.166074
Scaling-up antiretroviral therapy in Malawi