Strategies for the scale-up of antiretroviral therapy in South Africa through health system optimization.

In the face of the massive burden created by human immunodeficiency virus/acquired immunodeficiency syndrome and other infectious diseases, developing nations must find ways to rapidly begin treatment for infected persons. Although infusions of personnel, supplies, and diagnostics would make a major contribution to expanding the capacity to treat these diseases, the lack of these resources creates a long-term challenge, and there is a need for additional approaches to spread effective interventions that can leverage existing resources and the much-needed infusions of new resources. This article describes one such approach-applied in several forms in South Africa-that aims to significantly increase the number of patients receiving antiretroviral therapy.