Senior fellow Mead Over was interviewed by ONE on sustainable AIDS treatment.
From the Article
Your new book is called Achieving an AIDS Transition: Preventing Infections to Sustain Treatment. Define for us what you mean by an “AIDS transition.”
When we place people on treatment, we accomplish a great good because we prolong their lives, and in the case of the adults, we allow them to continue parenting, contributing to their local economy, enjoying their lives. Unfortunately, medicines cost hundreds a year and must be taken every day for the rest of an individual’s life, so when we expand treatment, the positive effect is counterbalanced by the fact that we’ve added to the fiscal burden of AIDS treatment. I would also argue that it’s not good for a country for a large percentage of its citizens to be reliant on a pill that comes from another country. I believe that young Africans, as they grow older and remain dependent, will come to resent this.
So the challenge is to find a path towards sustainability of AIDS programs in poor countries. We need a milestone we can reach on the way to a world without AIDS. The AIDS transition is such a milestone for a given country or for Africa as a whole. I define it as holding down the annual number of AIDS deaths, while pushing the annual number of new infections even lower. To hold the mortality rate down, it’s not sufficient just to sustain current treatment levels. We have to add a substantial number of new people to treatment each year to sustain progress. But the more people we add to treatment rolls the more effectively we must reduce new infections in order to achieve the AIDS transition in any given year. And the larger the fiscal burden until the transition is reached. Donors and recipient governments must decide how to trade off the goals of treatment access and fiscal burden.