‘Education and prevention would be a better use of the money…’

  Of course, prevention is better than cure and ImpAcTAIDS is all in favour of supporting all the efforts, both local and international, to prevent further transmission of HIV.  However, to do nothing apart from provide palliative treatment for the millions of people already infected with HIV is not only morally wrong; it compounds the problem in several ways:

  Firstly, without an effective treatment, there is little or no incentive for people to come forward for HIV testing.  HIV remains a massive stigma, which individuals, communities and governments alike are afraid of and reluctant to address constructively.  HIV positive people who 'come out' often suffer discrimination at least through to physical attack or rejection by their families and neighbours at worst. There is also little incentive to practise safe sex for those who suspect or are already aware of their HIV diagnosis in order to protect others.  The entire social fabric of a community can fall apart.

  Treating opportunistic infections such as thrush or chest infections, TB etc., may prolong life, but this is usually at most for only one year.  It does not necessarily mean that that person becomes well enough to cultivate the year's crops or to return to work.  Some authorities even argue that it prolongs life just when patients have the highest viral load and are therefore at their most infectious…

  On the other hand, take the case of a single lady in Africa, with advanced AIDS, who is no longer strong enough to work or to grow food to feed either herself or her four young children.  All she has to look forward to is a slow, but certain death, with the constant worry of who will look after her children when she dies.  Her eldest child may even end up turning to prostitution as the only way to support her self and the other orphans, with all the risks to her own life that that entails…

  However, if you treat this one lady, not only one life would be prolonged; four others would be saved or at least have a meaningful future.  That lady would be able to regain almost full health and be able to function properly as a mother, an earner and a useful member of the community.  The likelihood is that she would stick to her treatment, because she knows the consequences of not doing so.  She might in turn help others in the fight against AIDS in her neighbourhood.  People would see her well again and realise that there is hope, and that it is worth changing their behaviour…