Treatment Not 'Economical' Way To Fight Global HIV/AIDS; Prevention Would Save More Lives, Money, Opinion Piece Says

"It is humane to pay for AIDS drugs in Africa, but it isn't economical," and spending money on prevention would save more lives, economist Emily Oster writes in an opinion piece in the July 25 issue of... Forbes. By comparing the number of years of life saved by antiretroviral drugs with the number of years saved by other interventions, such as education, Oster shows that treatment is the most expensive way to fight the disease but is not the most effective. For example, if a regimen of generic antiretroviral drugs cost $1 per person per day, and one year of drug therapy saves one year of life, then each life-year costs $365, excluding the cost of delivering the drug to the patient, Oster says. However, using antibiotics to treat sexually transmitted diseases that produce open sores -- such as gonorrhea, syphilis and genital warts -- and therefore increase a person's risk of contracting HIV would cost just $3.65 per year of life saved, according to Oster. In addition, estimates from an aggressive education campaign in Uganda indicate that education would save lives at just $16 annually per year of life. "It may be that we have an objective other than maximizing the efficiency of dollars spent," Oster says, noting that providing hope to millions of Africans who are parents might "have value in and of itself." Oster continues, "But if we choose treatment, we must know what we are giving up. The tradeoffs are there whether we want to face them or not," concluding, "What economics can do is tell us -- in numbers, in black and white -- what we give up and what we gain" (Oster, Forbes, 7/25).


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