Evaluation of treatments for HIV-associated Kaposi sarcoma in Africa

We write to comment on the recent article by Coldiron and colleagues [1] that describes Mdecins Sans Frontires' programmatic use of pegylated liposomal doxorubicin (PLD) for treatment of HIV-associated Kaposi sarcoma (KS) in Mozambique. Their discussion raises the important and very pertinent issue of health systems barriers to effective and sustainable cancer treatment in low-and middle-income countries, which is a problem for all cancers, not just for KS. That said, we wish to register our concerns about some of the particulars of their study and their interpretation of the data.