Universal HIV treatment could improve education
Improving access to HIV treatment, counselling and testing would also lead to better-quality education in regions worst hit by the disease, by cutting its impact on teachers, a study has found.
Providing teachers with universal access to antiretroviral therapies and voluntary counselling and testing across Sub-Saharan Africa, the Caribbean and the Mekong region of South-East Asia would increase teacher numbers by reducing absenteeism and death, according to the study published in PLOS One last month (16 November).
This would improve the quality of education and teacher-to-pupil ratios — in line with the UN Educational Scientific and Cultural Organisation's (UNESCO) Education for All (EFA) initiative — and, in many countries, save money that would otherwise be spent on training new staff, sick pay and death payments.
"Treating teachers for HIV/AIDS is not the whole solution, but it is a very doable and cost-effective way to improve the quality of and access to education," says Claire Risley, a researcher at Liverpool University's Institute of Infection and Global Health, United Kingdom, and co-author of the report.
The study estimates that 265,000 teachers — more than 95 per cent of whom teach in Sub-Saharan Africa — currently live with the disease.
Ensuring universal access to treatment, defined as reaching 80 per cent of those in need, would reduce teacher deaths and absenteeism by around 40 per cent by 2015, the study says.
This could save 47,000 lives and 50,000 teaching years over that period in Sub-Saharan Africa alone, where the impact would be greatest because of a combination of high disease burden and low levels of current treatment levels, the study says.
If treatment and testing are immediately scaled up in the region, spending an extra US$219 million on them between 2009 and 2015 could save US$874 million over this period in costs associated with replacing teachers, it finds.
Yet the benefits in cost reduction vary among the regions.
In the Caribbean, only treatment could be justified in relation to cost-efficacy to the education sector, while in the Mekong region, neither treatment nor counselling and testing access would provide net savings, the study says.
Nonetheless, the positive impact on education quality, as well as the social benefits, means that providing universal treatment is an important tool for realising EFA goals, it says.
By providing the study's model for free online, Risley hopes the study could be improved upon and adapted for individual countries' needs.
The costing data provided by the report is "extremely important and useful," says Chris Castle, chief of UNESCO's HIV and Health Education section.
But he raises concerns that the data, mostly collected in 2008, is now out-of-date.
He adds that he would like to see a more recent study, which, considering recent reductions in treatment costs, would probably provide even more compelling evidence to act.
While the study highlights the benefits of treatment to education, the impact can go both ways, says Lesley Drake, executive director of the Partnership for Child Development.
"Education itself is a vaccine," she tells SciDev.Net. "Just keeping children in school makes them less likely to be HIV positive."
PLOS One doi:10.1371/journal.pone.0042909 (2012)