5 years to end HIV and AIDS transmission in Africa

This story was originally covered by PRI’s The World. For more, listen to the audio above.

In the years since AIDS was first identified as a pandemic, epidemiologists have struggled to figure out how to stop transmission of the disease. “Almost everything that we’ve tried as interventions against HIV has failed to reduce the rate at which new cases are happening, particularly in southern Africa,” John Hargrove of the South African Center for Epidemiological Modeling and Analysis told PRI’s The World. “We need to think outside of the box, we need something new.”

Hargrove’s idea is known as test and treat. He and his colleagues want to test everyone every year. And when people test positive, treat them right away. Today in South Africa, if a person tests positive for HIV, they’re given counseling and another test to determine the strength of their immune systems. Anti-retroviral medicines are given to people only once their health begins to fail.

Under test and treat, everyone who tests positive for HIV would be put on antiretroviral drugs as soon as possible. The drugs would be used to stop the spread of the disease, more than they would be to protect the health of the patient. Hargrove cites a mathematical model that suggests a large-scale implementation of test and treat could stop the transmission of HIV in Africa in just 5 years.

Not everyone is on board with Hargrove’s plan. ” There really isn’t evidence that it will work,” Catherine Tomlinson, a senior researcher for the Treatment Action Campaign told The World. “At this point there’s more evidence that it could be potentially harmful for the individuals.”

ARVs have serious side effects, Tomlinson told The World, so the plan could make people less healthy than they would have been otherwise. And, if people start treatment too early, they could develop a resistance to the drugs. According to Tomlinson, “By the time [people with HIV] get to the point that they need treatment for their own health, there’ll be a risk that the treatment that they were started on no longer works.”

Critics also point out that test and treat would cost more money than current, more limited treatment programs. Hargrove, however, dismisses the concern.

“You will spend the same amount of money by 2050 whichever route you take,” he told The World. “The difference will be with our scenario in 2050 there will be no more epidemic. If we continue to do what we’re doing right now, unless there is a massive change in people’s behavior, we’ll still have the same epidemic in 2050. Nobody wants that.”

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