The study uses data from the KwaZulu-Natal province in which the researchers used a mathematical model to predict the impact of drug allocation strategies that the South African government is implementing to treat half a million people by 2008.  They looked at three different allocation strategies, one that would have drugs available only to the city of Durban and two making the drugs available in urban and rural areas.  

Out of those three strategies, sending medication to Durban-only is calculated to be the most effective in preventing new infections.  It could reduce the infection rate by 46 percent.  This would save over 15,000 people from becoming infected by 2008.  The strategy also would generate the least amount of drug resistance and avert the greatest amount of deaths.

There are ethical problems with that strategy because of the disparities between urban and rural healthcare.  The gap in quality of care is already too great and limiting access to lifesaving drugs would just make things worse in rural areas.

The following are results from their research using the Durban-only model:

• Transmission would fall 25 percent to 46 percent in Durban but by less than 5 percent in rural areas.
• Transmitted resistance to antiretroviral drugs would increase 0.4 percent to 5.5 percent in Durban but would not emerge in rural areas.
• Death rates from AIDS would fall by a median 42 percent in Durban but by only 0.1 percent in rural areas.

Under the rural/urban drug sharing strategy, the results on transmission, drug resistance and death rates would be similar. For instance:

• Transmission would decrease by 11 percent to 28 percent in Durban and by 17 percent to 37 percent in rural areas.
• Resistance would hover between 0.1 percent and 3 percent in the city and 0.2 percent to 4.5 percent in rural areas.
• AIDS-related deaths would fall a median 26 percent in Durban and 34 percent in rural communities.

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