The US President's Emergency Plan for AIDS Relief prevented about 1.2 million deaths in 12 nations between 2004 and 2007, according to a new study by Stanford University School of Medicine researchers. The study compared data on 12 PEPFAR-targeted African nations with 29 control nations, also in Africa.

"It has averted deaths - a lot of deaths - with about a 10 percent reduction compared with neighboring African countries," said study co-author Dr. Eran Bendavid. "It is making a palpable and discernable impact," he said. "However, we could not see a change in prevalence rates that was associated with PEPFAR."

HIV/AIDS mortality rates climbed in all of the countries in the study in the early period leading up to PEPFAR's 2003 launch, the researchers found. After the initiation of the program, HIV/AIDS deaths began falling in the PEPFAR countries. Later in the study period, HIV/AIDS deaths were 10.5 percent lower in PEPFAR nations than in control countries. PEPFAR spending amounted to about $2,450 for each life saved, the investigators said.

"This is not a trivial cost, and PEPFAR will need to make the available resources go a long way to continue changing the course of the epidemic," Bendavid said. "There has to be a very strong focus on prevention, especially when the number of people infected is still staggeringly high."

The full report, "The President's Emergency Plan for AIDS Relief in Africa: An Evaluation of Outcomes," will be published in the May issue of Annals of Internal Medicine (2009;150(10)).