International AIDS Efforts in Africa ‘Admirable’ But Not Worthwhile, Op-Ed Says
As "admirable" as the passion fueling international AIDS efforts in Africa may be, "effective AIDS treatment ... confronts a host of potentially insurmountable barriers" on the continent, Roger Bate, director of the South African non-governmental organization Africa Fighting Malaria, writes in a Wall Street Journal Europe op-ed. In addition, "the international community's continuing overemphasis on AIDS masks the immediate and large threat of malaria and respiratory disease" on the continent, conditions that, unlike AIDS, are "genuinely curable," Bate writes. While $100 million in combined AIDS funding from the Bill and Melinda Gates Foundation and Merck incite "optimism," Bate notes, "Private initiatives alone cannot alleviate the AIDS pandemic" when many African nations' health budgets allocate less than $10 per person annually. Furthermore, recent offers from international drug companies to provide discounted AIDS drugs do not present an approach that is "feasible, due to low capacity to deliver treatment." Bate writes, "AIDS programs are expensive and will divert funding from child immunization, oral rehydration therapy for dysentery, removal of malaria mosquito breeding grounds and delivery of clean water, all of which save many more lives at much lower cost than AIDS prevention, let alone treatment, which only delays death and does not cure." The administration of AIDS drugs is an "onerous task" that requires routine monitoring and testing, and "Africa's widespread incapacity to test who should have what doses of what medicines, then ... deliver medicines correctly every hour of every day, is the real stumbling block for AIDS treatment in Africa," he writes. Bate also states that though many companies operating in Africa have "stepped in to assist proper treatment" with their own clinics or by funding others, the "unintended consequences of such corporate action is to polarize communities." While employed families receive treatment, the unemployed do not. Bate concludes, "It does seem inevitable that an AIDS fund will be established, probably run by the World Bank, which will bring treatment to many AIDS victims in Africa. Anyone arguing against such a fashionable, seemingly beneficent program will earn himself few friends. But it does seem paradoxical -- nay, tragic -- that the world may end up spending tens of billions of dollars annually to provide painful, only moderately successful treatment to prolong life, while not making millions of people healthy from curable diseases like malaria for only a few billion. In these days of emotional politics, perhaps the rich world will only spend money on diseases with which it has some familiarity" (Bate, Wall Street Journal Europe, 6/13).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.