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Global Update - AIDS: Panel Warns That Without New Direction, Epidemic Will Remain Out of Control at 50

The New York Times - November 3, 2009
Donald G. Mcneil Jr.


Unless there is a drastic change in approach, the AIDS epidemic will still be out of control on its 50th anniversary in 2031, a panel of AIDS experts predicted in an analysis being published Tuesday in the journal Health Affairs.

The lead author, Robert Hecht, an economist and former policymaker at the United Nations and the International AIDS Vaccine Initiative, predicted that by that time, poor countries would need $35 billion a year -- three times what is spent now -- to treat AIDS patients, care for orphans and do prevention work.

Even under the best case foreseen by the panel, more than one million people would be newly infected each year. (About 2.3 million were infected in 2007.) Achieving that outcome would cost $722 billion over 22 years, or nearly $8,000 for each infection prevented. (Condoms are cheap, but the price includes drugs that lower viral levels and prevent mother-to-child transmission.)

Their economic models assumed that condoms, drugs and circumcision would become widespread but that a microbicide and a vaccine would not.

Rapidly developing countries like Brazil, China, India, Mexico and Russia should be able to pay for fighting their own relatively small epidemics, the authors said. Southern African countries will need only some help, despite having the world's highest AIDS rates. But much of Africa, and especially Kenya, Mozambique, Uganda and Zambia, will remain heavily dependent on donors.

Given the economic crisis, rich countries may come up with only 30 percent of what is needed; they come up with 43 percent now.

"We're staring at the face of a huge crisis," Mr. Hecht said.


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