Financial Times Editorial - How to fight Aids

Financial Times Editorial - How to fight Aids
Copyright The Financial Times Limited 2006
Published: August 17 2006 03:00 | Last updated: August 17 2006 03:00


Twenty-five years after Aids was first identified, much progress has been made in developing treatments for patients in the rich world. But, as the continued burden of 2.8m deaths and 4.1m new HIV infections each year shows, much more is still required, particularly in poorer countries.

While researchers continue to find new ways to stave off resistance and reduce side effects of antiviral drugs, there have been few signs at this week's International Aids conference in Toronto of the scientific breakthroughs required for an effective vaccine or microbicide to prevent infection, let alone a cure for the disease.

However, there are many indications that existing resources are not being used efficiently. There is a case for bringing more management into the science, and more science into the management, of the epidemic. On the research front, that means designing clinical studies more rigorously, so that likely failures can be weeded out quickly and limited resources devoted to the truly promising options.

Equally, it requires greater efforts to assess the cost and effectiveness of existing prevention, testing and treatment programmes. The Global Fund to fight Aids, TB and Malaria, for instance, could find better ways to stimulate and reward good proposals by countries applying for support. That means finding more sophisticated tools than the very crude indicators used today to evaluate their efforts.

Care also needs to be taken to ensure that investment in Aids programmes does not come at the expense of other health interventions, as staff are hired away and poorly resourced local officials pulled in contradictory directions.

A constructive approach to the challenge of Aids requires greater funding efforts by politicians who - with the exception of former US President Bill Clinton - have been noticeably absent this week in Toronto. Even Stephen Harper, Canada's own prime minister, failed to show up, despite the presence of 24,000 delegates and the global media attention given to the conference.

Just as important as funding by governments is their political support for policies driven by pragmatism and science, not prejudice and misplaced morality. Above all, this means having courage to recognise that distributing condoms and clean syringes - and working with sex workers rather than condemning and alienating them - can save lives and limit the broader spread of HIV. The US has set a good example with its relatively generous financial contributions but not with the "moral" restrictions that it places on their use.

The reality is that many factors contributing to Aids' continued spread are to do with social values and women's rights and status, as well as nutrition, sanitation and poverty in general. These issues go beyond the competence of drug researchers or public health experts - but that is no excuse for not trying to do more.