How To End AIDS Without a Cure

Despite all the talk of exciting scientific advances, there may be a simpler approach to ending the epidemic than a cure.

Because antiretroviral therapy renders people with HIV effectively non-infectious, one way to rid the world of the virus is to be more vigilant about testing and more aggressive in immediately treating those who become infected. Public health expert Brian Williams of the South African Centre for Epidemiological Modeling and Analysis says that this “Test and Treat” strategy could halt the spread of HIV in five years and end the epidemic altogether in 40 years. 

But others, including President Obama’s public health advisor Ezekiel Emanuel, don’t believe that we can treat our way out of HIV/AIDS. In a Huffington Post op-ed, Emanuel responds to critics who claimed that the Obama administration’s policies were causing deaths in Africa. “There is not a one-to-one relationship between the input of dollars spent and the output of improved health or lives saved,” he says.

In his Big Think interview, physician and activist Paul Bellman responds to Emanuel’s claim, arguing that treatment as prevention is a viable public health strategy.

The downside to this strategy is the cost. “Test and Treat” would cost $3-4 billion a year in South Africa alone, Williams estimates. Given the economic state of the West, this kind of massive global initiative seems highly unlikely.