BACKGROUND: A consensus conference was held to discuss priorities for antiretroviral therapy (ART) research in Zambia, one of the world's most heavily HIV-afflicted nations. Zambia, like other resource-limited settings, has increasing access to highly active antiretroviral therapy (HAART) because of declining drug costs, use of government-purchased generic medications, and increased global donations. For sustained delivery of care with HAART in a resource-constrained medical and public health context, operational research is required and clinical trials are desirable. The priority areas for research are most relevant today given the increasing availability of HAART. METHODS: A conference was held in Lusaka, Zambia, in January 2002 to discuss priority areas for ART research in Zambia, with participants drawn from a broad cross section of Zambian society. State-of-the-art reviews and 6 intensive small group discussions helped to formulate a suggested research agenda. RESULTS: Conference participants believed that the most urgent research priorities were to assess how therapeutic resources could be applied for the greatest overall benefit and to minimize the impact of nonadherence and viral resistance. Identified research priorities were as follows:Conference participants recommended that HIV-related clinical care and research be integrated within home-based care services and operated within the existing health delivery structures to ensure sustainability, reduce costs, and strengthen the structures. CONCLUSION: Our consensus was that antiretroviral clinical trials and operational research are essential for Zambia to address the new challenges arising from increasing ART availability. There is global consensus that antiretroviral clinical trials in resource-constrained countries are possible, and the capacity for such trials should be developed further in Africa.
BACKGROUND: A consensus conference was held to discuss priorities for antiretroviral therapy (ART) research in Zambia, one of the world's most heavily HIV-afflicted nations. Zambia, like other resource-limited settings, has increasing access to highly active antiretroviral therapy (HAART) because of declining drug costs, use of government-purchased generic medications, and increased global donations. For sustained delivery of care with HAART in a resource-constrained medical and public health context, operational research is required and clinical trials are desirable. The priority areas for research are most relevant today given the increasing availability of HAART. METHODS: A conference was held in Lusaka, Zambia, in January 2002 to discuss priority areas for ART research in Zambia, with participants drawn from a broad cross section of Zambian society. State-of-the-art reviews and 6 intensive small group discussions helped to formulate a suggested research agenda. RESULTS: Conference participants believed that the most urgent research priorities were to assess how therapeutic resources could be applied for the greatest overall benefit and to minimize the impact of nonadherence and viral resistance. Identified research priorities were as follows:Conference participants recommended that HIV-related clinical care and research be integrated within home-based care services and operated within the existing health delivery structures to ensure sustainability, reduce costs, and strengthen the structures. CONCLUSION: Our consensus was that antiretroviral clinical trials and operational research are essential for Zambia to address the new challenges arising from increasing ART availability. There is global consensus that antiretroviral clinical trials in resource-constrained countries are possible, and the capacity for such trials should be developed further in Africa.
Authors: P Farmer; F Léandre; J S Mukherjee; M Claude; P Nevil; M C Smith-Fawzi; S P Koenig; A Castro; M C Becerra; J Sachs; A Attaran; J Y Kim Journal: Lancet Date: 2001-08-04 Impact factor: 79.321
Authors: Paul Kelly; Isaac Zulu; Beatrice Amadi; Mwansa Munkanta; Jacqueline Banda; Laura C Rodrigues; David Mabey; Roger Feldman; Michael J G Farthing Journal: Acta Trop Date: 2002-08 Impact factor: 3.112
Authors: A Cozzi Lepri; A N Phillips; A d'Arminio Monforte; F Castelli; A Antinori; A de Luca; P Pezzotti; F Alberici; A Cargnel; P Grima; R Piscopo; T Prestileo; G Scalise; M Vigevani; M Moroni Journal: AIDS Date: 2001-05-25 Impact factor: 4.177
Authors: R Handema; H Terunuma; F Kasolo; H Kasai; M Sichone; G Mulundu; X Deng; K Ichiyama; S Mitarai; M Honda; N Yamamoto; M Ito Journal: AIDS Res Hum Retroviruses Date: 2001-05-20 Impact factor: 2.205
Authors: J S Stringer; D J Rouse; S H Vermund; R L Goldenberg; M Sinkala; A A Stinnett Journal: J Acquir Immune Defic Syndr Date: 2000-08-01 Impact factor: 3.731
Authors: Sarah C Haynes; Lindsey Rudov; Elizabeth Nauman; Lindsay Hendryx; Rebekah S M Angove; Thomas Carton Journal: Med Care Date: 2018-10 Impact factor: 2.983