Forecasting the Population-Level Impact of Reductions in HIV Antiretroviral Therapy in Papua New Guinea

Papua New Guinea (PNG) recently did not secure external funding for the continuation of its antiretroviral treatment (ART) programs meaning that supplies of HIV drugs for the estimated 38,000 people living with HIV in PNG could be completely depleted during 2010. Using a mathematical model of HIV transmission calibrated to available HIV epidemiology data from PNG, we evaluated the expected population-level impact of reductions in ART availability. If the number of people on ART falls to 10% of its current level, then there could be an approximately doubling in annual incidence and an additional 12,848 AIDS-related deaths (100.7% increase) over the next 5 years; if ART provision is halved, then annual incidence would increase by ~68%, and there would be an additional ~10,936 AIDS-related deaths (85.7% increase). These results highlight that maintenance of ART and associated services through external funding is essential for the health and well-being of HIV-positive people in PNG.