Perspective Convergence of Mortality Rates among Patients on Antiretroviral Therapy in South Africa and North America

In the early 2000s, the pages of medical journals were filled with (often rancorous) debates about the feasibility and prudence of expanding access to antiretroviral therapy (ART) in sub-Saharan Africa, where HIV disease had become the leading cause of death among young adults. Despite a paucity of supporting data, some public health experts warned of ‘‘antiretroviral anarchy’ ’ in Africa and the resulting spread of poly-resistant strains of HIV to wealthy countries [1,2,3]. Shortly after HIV treatment scale-up began in earnest across the continent, however, adherence to ART in Africa wa