Policies to tackle HIV/AIDS

These policy briefs, published as a supplement to a series of articles in Health Affairs, ask what policymakers can do to reduce the global burden of HIV/AIDS.

Around 33 million people are thought to be infected with HIV — the virus that causes AIDS — with an estimated 2.3 million new infections each year. Modelling studies suggest the annual cost of tackling HIV/AIDS will reach up to US$35 billion by 2031.

Donors must step up to the funding challenge, say the policy briefs. The authors suggest donors should focus on the poorest countries hardest hit by HIV/AIDS, arguing that middle-income countries can and should contribute more toward HIV treatment costs.

The policy briefs emphasise the need to invest in research — both to develop new HIV vaccines, and understand how the body responds to HIV infection and how disease develops.

Research into prevention or cure of infections such as tuberculosis that increase the chances of contracting HIV is also important. As is prioritising cost-effective treatment such as fixed-dose combinations that combine several drugs into one pill, or antibiotics that prevent 'opportunistic' infections such as pneumonia.

Other prevention strategies that deserve more support include circumcising adult males — which has been shown to reduce HIV infection by 40–76 per cent — and increasing access to methadone as substitution therapy for heroin dependency.

Improving education and training should be high on the agendas of donors and policymakers. This includes helping AIDS-affected countries use best practices by training healthcare workers, and reducing the number of people's sex partners through public awareness campaigns.

Reducing the vulnerability of key social groups, such as injecting drug users or women in impoverished countries, is also critical, suggest the policy briefs.

Women account for 60–70 per cent of new infections in Africa. Expanding microfinance programmes on the continent would give this key group economic independence and reduce their vulnerability to HIV infection.

Similarly, providing housing to HIV-infected homeless people could improve access to treatment programmes and adherence to medication regimes in this vulnerable group.

Link to full articles in Health Affairs