Let Us Not Forget Our ABCs

A recent article in the Washington Post ("Gilead AIDS Drug Shows Prevention Promise") heralds promising new scientific results that use of an anti-retroviral drug among healthy people may prevent transmission of HIV/AIDS. Trials in monkeys showed complete protection despite repeated exposure to HIV over the course of more than three months, and according to the article "if larger tests show the drugs work, they could be given to people at highest risk of HIV—from gay men in American cities to women in Africa who catch the virus from their partners."Although such scientific breakthroughs are important, we can not afford to count on expensive technological and pharmaceutical solutions to preventing the spread of the HIV/AIDS pandemic in poor countries—especially as that emphasis detracts from proven behavior change interventions. Global resource mobilization efforts for HIV/AIDS, including PEPFAR, the Global Fund and the World Bank programs, have tripled donor spending to $8 billion in 2005 but managed to reach only approximately 10% of AIDS patients in poor countries with anti-retroviral treatment. In addition, there is some anecdotal evidence that the increasing attention and access to treatment is decreasing the emphasis on prevention strategies among donors, communities and government planners. Like many, I welcome the dream of having a miracle pill to provide vulnerable women in Africa. However, what we really need to do is re-invigorate and re-focus on proven, cost-effective prevention techniques—including the ABCs.