Editorial: Fighting AIDS on Limited Budgets

Editorial: Fighting AIDS on Limited Budgets
Copyright by The New York Times
Published: July 16, 2010
http://www.nytimes.com/2010/07/17/opinion/17sat3.html?th&emc=th


With the AIDS epidemic still spreading rapidly around the globe, public health programs have to use their resources a lot more effectively. The need for greater efficiency in a time of limited resources is an important theme of President Obama’s new national AIDS strategy. The same argument is being made by the United Nations agency that battles the epidemic and by Bill Gates, whose foundation plays an influential role in financing a global response.

While drug treatments are keeping more people infected with the AIDS virus alive in the United States, the number of new infections of H.I.V. has held steady at about 56,000 a year. The White House strategy aims to reduce that number by 25 percent over the next five years and to substantially increase the percentage of people who get tested and treated promptly.

To meet those goals, it calls for redirecting some of the $19 billion that the federal government currently spends annually on domestic AIDS programs to areas where the need is greatest and to groups at greatest risk, such as gay and bisexual men, blacks, Latinos and injection drug users. That sounds reasonable in tough times.

In the developing world, where drug treatments are also saving many lives, new infections are occurring at a faster rate than treatment is being provided. According to estimates from the United Nations, only a third of the 15 million people who need treatment are getting it and $27 billion a year is needed for the global fight — roughly $10 billion to $11 billion more than is now spent.

The United Nations agency is calling for a concerted effort to develop a less-costly and less-toxic single dose pill and simple, cheaper diagnostic and monitoring tests. It is calling for redirecting contributions away from middle-income countries such as China, India and South Africa, which should bear more of their own burden, to free up more money for poorer nations.

A final victory over AIDS will require research breakthroughs. Scientists seem increasingly optimistic that a vaccine will ultimately prove feasible. But that is still a distant dream.