“The lives of more than 740,000 people in nine African countries were saved between 2004 and 2008 by the U.S. President’s Emergency Plan for AIDS Relief [PEPFAR],” according to a study conducted by Stanford University School of Medicine researchers and published in the Journal of the American Medical Association (JAMA) on Wednesday, HealthDay News reports (3/15). “The study is the first to show a decline in all-cause mortality related to the program,” a Stanford press release notes, adding, “To measure the impact of the program, [Eran Bendavid, assistant professor of medicine at Stanford,] and his colleagues analyzed health and survival information for more than 1.5 million adults in 27 African countries, including nine countries where PEPFAR has focused its efforts” (Richter, 5/10). According to the study, “an estimated total of 740,914 all-cause adult deaths were averted between 2004 and 2008 in association with PEPFAR,” and “[i]n comparison, PEPFAR was associated with an estimated 631,338 HIV-specific deaths averted during the same period,” a JAMA press release states, noting that “all-cause adult mortality declined more in African countries in which … PEPFAR operated more intensively” (5/15).

“Researchers had previously shown that the initiative … had prevented deaths from AIDS,” but “it was unclear if more people in those countries were only dying of tuberculosis or malaria instead, researchers explained,” Reuters writes. “There were concerns that there’s been this shift in physicians and nurses (toward HIV clinics) to the detriment of other public health concerns,” Bendavid said, adding, “We can’t find evidence of unintended harms — or benefits. More or less we find that PEPFAR seems to have been very effective at reducing deaths, probably mostly HIV-specific deaths,” according to Reuters. The news agency adds, “There’s still some question as to whether or not the billions of dollars the U.S. puts toward the program has been worth those benefits, however” (Pittman, 3/15). In an accompanying editorial, Ezekiel Emanuel of the University of Pennsylvania, writes, “The fundamental ethical, economic, and policy question is not whether PEPFAR is doing good, but rather whether other programs would do even more good in terms of saving life and improving health,” according to the JAMA press release (5/15).