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Can At-Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?

Adrienne Lucas and Nicholas L. Wilson
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Nicholas L. Wilson: Department of Economics, Reed College, and Office of Evaluation Sciences Author email: nwilson@reed.edu

American Journal of Health Economics, 2018, vol. 4, issue 3, 358-382

Abstract: The single largest item in the US foreign aid health budget is antiretroviral therapy (ART) for the treatment of HIV/AIDS. Many supply- and demand-side factors in sub-Saharan Africa could cause smaller than expected epidemiological effects of this at-scale drug provision. We provide what appears to be the first quasi-experimental evidence on the effect of at-scale drug provision in a poor country, using the phased rollout of ART in Zambia, a setting where approximately one in six adults are HIV positive. Combining anthropometric data from national household surveys and a spatially based triple-difference specification, we find that local ART introduction increased the weight of high HIV likelihood adult women. This finding from a clinically difficult setting suggests that the generalized challenges of scalability of ART for adult health in sub-Saharan Africa are surmountable.

Keywords: foreign aid; health; HIV/AIDS; PEPFAR; targeting; Zambia (search for similar items in EconPapers)
JEL-codes: H40 H51 I12 J13 O12 (search for similar items in EconPapers)
Date: 2018
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Journal Article: Can At-Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa? (2018) Downloads
Working Paper: Can at Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa? (2017) Downloads
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