financial times editorial: turning our backs on avoidable HIV/AIDS deaths in a time of scarce resources (0100)

Preventing Aids
Published: November 30 2009

Politicians cannot turn their backs on Aids, which still kills 2m people a year, while 33.4m have HIV. But they must improve how they spend future funds.

In many countries, HIV remains a leading cause of disease, a substantial burden on healthcare and a brake on economic development. Political attention and funding has resulted in progress in tackling the virus, with a significant rise in the number of people receiving treatment, and a decline in the rate of new infections.

President Jacob Zuma deserves credit for overturning the Aids denialism of Thabo Mbeki, his predecessor, in South Africa, one of the countries with the heaviest burdens of the disease today. But the surge in financial support to poorer countries since the turn of the decade has come without sufficient effort to ensure effectiveness. World leaders need to consider how best to invest further resources.

One pressing issue is the need to balance HIV with other priorities. Without broader support for healthcare, HIV spending risks draining scarce medical workers away from other priorities.

The current focus has at times diverted attention from closely related illnesses such as tuberculosis. In many countries, other unrelated debilitating diseases which could be treated cheaply have been neglected by a disproportionate focus on Aids. More attention is needed to fund broader health programmes, particularly those for mothers and their children.

A second issue is better use of HIV money. Less than half of those who need medicines receive them, but expanding treatment risks creating an unfortunate trade-off with prevention.

At a time of scarce resources, reducing the number of new infections – which stood at 2.7m people last year – is essential if Aids is to be tackled. Yet much of the money currently spent is not sufficiently targeted to those groups most at risk, whether injecting drug users in Russia, African-Americans in Washington DC, or the gay community in the UK.

Donors, recipient countries and intermediaries providing treatment need to ensure that patients are closely monitored to limit the risk of drug resistance. Prevention must focus on policies proven to work, which vary between countries, such as simple drugs to treat expectant mothers and newborn children; circumcision; education campaigns; and condom and clean syringe distribution projects. Otherwise, many more will die unnecessarily.

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