OUAGADOUGOU, Dec 12 (AFP) - Providing HIV awareness counselling to prostitutes is more than 2,000 times more cost-effective as a life-saver in Africa than treating AIDS victims with anti-retroviral drugs, researchers said Wednesday.
Advising urban sex workers on risky practices and giving them condoms so that they do not spread the virus costs just 1.32 dollars per year per life saved, according to a team from Institute for Human Development at the University of California at Berkeley.
By comparison, administering the cocktail of anti-retroviral drugs to extend the lives of people who already have the virus costs around 3,800 dollars per year per life saved.
Even if cheaper generic anti-retroviral drugs are used, rather than costlier patented equivalent ones, the bill from treatment is still very high.
Giving generics that would cost less than 40 percent of current patented prices would still cost 3,016 dollars per life-year saved.
This is because of the high fixed costs of drug administration, such as having qualified medical personnel to monitor patients' progress, which cannot be eliminated however cheap the medication.
The study, presented here at a major conference on AIDS in Africa, drives at the heart of the problem of how to get the best value for money from slender resources in the fight against the pandemic.
Emiko Masaki, a Japanese researcher at Berkeley who made the presentation, said the figures were emphatic proof that precious dollars should be focussed far more on preventing AIDS rather than treating it.
"Treatment and preventing are competing for the same funds," she said. "But resource allocation decisions affect the number of lives saved. Prevention should take a higher priority over treatment."
Among medications, the most cost-effective is nevirapine, when given to pregnant mothers to prevent them from handing on the virus to their babies.
That costs 11 dollars per life-year saved.
Other highly cost-effective ways of stretching the anti-AIDS dollar include encouraging people to undergo blood tests for the virus and providing them counselling on safe sex. These cost between 22 and 30 dollars per life-year saved.
The research is based on a comparison of seven previous studies on HIV prevention and treatment in sub-Saharan Africa, and the team's own estimates of drug costs.
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