Why are clinical trials for HIV treatment being carried out in Africa?
In Africa most countries rely on the World Health Organisation (WHO) guidelines for a Public Health approach to Scaling up ART in resource-limited settings. These WHO guidelines were highly challenging to produce, because of an inadequate evidence base for the delivery and use of antiretroviral (ARV) drugs in high HIV prevalence countries with limited capacity and health infrastructure. They had to be based on the results of trials and clinical experience gained in the USA and Europe, where the standard of care is: individual patient management by skilled physician-led health care teams, supported by frequent high-technology laboratory monitoring.While it was urgent that national treatment programmes began to provide access to the hundreds of thousands of HIV-infected Africans at high risk of dying, a local research agenda was needed in parallel so that the guidelines could be updated based on lessons learned in Africa.Some questions can be resolved by observational research and by eva
