Among the unresolved issues surrounding the AIDS pandemic is which strategy — pushing prevention techniques or HIV treatments — will best reduce the disease's spread. Now, World Health Organization (WHO) researchers say that annual testing and immediate drug treatment of those who test positive for HIV, the virus that causes AIDS, could within a decade virtually eliminate new cases of AIDS in the hardest-hit countries.
The findings, published this week in The Lancet, are based on a mathematical model. They don't reflect a change in WHO's current recommendation of voluntary testing, the agency says. "This is a theoretical exercise based on mathematical modeling to stimulate discussion," Kevin de Cock, head of WHO's AIDS department, told the Washington Post.
Some 33 million people — 22 million of them in sub-Saharan Africa — are HIV-positive. About 3 million are on anti-retroviral drugs (ARVs), but almost an additional 7 million need them, and current prevention efforts — which emphasize condom use, monogamy and abstinence — "are unlikely to eliminate this disease," according to an abstract of the paper. It would cost $1 billion to $7 billion annually to add universal testing and treatment to the current mix of prevention and care plans, the scientists say.
The New York Times reports today that the lives of 365,000 AIDS victims in South Africa may have been spared if the government there had provided life-extending drugs to patients and medicines to pregnant women to prevent them from passing HIV to their babies. The Times cites a study by scientists at the Harvard School of Public Health, which blames the deaths on the administration of former President Thabo Mbeki, who denied that HIV causes AIDS and that the widely used medications work against the disease.
The calculations are based on how many HIV-positive South Africans were given ARVs between 2000 and 2005, and how many could have gotten them if Mbeki's government had enacted an effective treatment program. Nearly 19 percent of the country's population, or 5.5 million people, is HIV-positive, according to the study.
The government's position was “a case of bad, or even evil, public health,” study author and virologist Max Essex told the Times. A PDF of the study is posted on the Web site of the school's AIDS initiative and will be published next month in the Journal of Acquired Immune Deficiency Syndrome.
An Mbeki spokesperson told the newspaper that the former president wouldn’t comment on the study's conclusions.
Check out ScientificAmerican.com's in-depth report on AIDS on Monday.
HIV-positive woman in Khayelitsha township outside Cape Town, South Africa by Trevor Samson/World Bank via Flickr