SciDev.Net (London)
27 November 2008
Scientists have proposed a radical new strategy to halt the HIV/AIDS epidemic, but its implementation could have human rights implications, say commentators.
Under the approach, published in The Lancet, people in the worst hit areas - Sub-Saharan Africa for example - would be tested for HIV annually and those found positive would be immediately put on antiretroviral (ARV) drugs.
The move could slash the number of new infections because AIDS drugs lower the levels of virus in the body, making transmission much less likely. The authors estimate it could cut infection rates to less than one percent within 50 years. Deaths could fall to 1 per 1,000 people a year by 2016.
But putting people onto ARVs immediately is controversial, due to the drugs' toxicity and side effects. Currently people are not put onto ARVs until they need them, and changing this practice raises the ethical issue of harming individual patients for public good.
The authors of The Lancet paper say that their strategy is a mathematical model for discussion, but that it offers a new option when other avenues, such as vaccines and microbicides, against HIV are failing.
Such a strategy would require substantial initial investment, but the lowering of transmission rates would result in far less expenditure on prevention, care and treatment, they say.
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