BMJ  2003;327:1104-1106 (8 November), doi:10.1136/bmj.327.7423.1104

Education and debate

Tackling HIV in resource poor countries

¹ Brigham and Women's Hospital, Division of Social Medicine and Health Inequalities, Boston, MA 02115, USA, ² Partners in Health, Boston, MA 02115, USA, ³ World Health Organization, Geneva, Switzerland

Focusing on prevention of HIV will not prevent the deaths of the millions already infected. The international community must adopt a strategy that links treatment and prevention

The first 150 words of the full text of this article appear below.

Despite recent proposals to expand access to antiretroviral treatment for people with HIV in resource poor settings, debate continues about the cost effectiveness of prevention and treatment strategies. This debate delays the urgent action needed to implement a comprehensive global AIDS strategy. To underscore the need to link prevention with treatment, we review the effect of HIV on economic and human development, the ways in which HIV prevention and treatment are mutually reinforcing, and the requirements for scaling up the response.

Why prevention is not enough

Prevention of HIV infection is often promoted as the only feasible option in resource poor settings despite the existence of drugs to treat it. As recently as 2002, experts argued that prevention should take priority over treatment for AIDS in Africa based on cost effectiveness.^{1 2} However, cost effectiveness analyses fail to take into account the most important reason for implementing widespread HIV treatment—treating sick people. Prevention strategies do nothing . . . [Full text of this article]

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Effect of HIV and AIDS on social and economic development

Linking treatment with prevention

Infrastructure: opportunities and constraints

New initiatives

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