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Funding Requirements Lead To ‘Difficult Trade-offs’ Between HIV Prevention, Treatment Efforts

The Hill: HIV in 2016: do we vaccinate now or pay more to treat later?
Jason Reed, epidemiologist and senior technical adviser with Jhpiego

“…To reach [the goal of an AIDS-free generation] … both approaches — primary prevention to protect uninfected people and drugs to treat those already HIV-infected — must be used simultaneously, without delay and almost universally. The Catch-22? There currently isn’t enough money to pay for both approaches at the levels required, leading to difficult trade-offs. … [For instance, the] current PEPFAR leadership has shuttered countless circumcision clinics in a rush to abide by extant U.S. congressional funding ‘earmarks’ for treatment. … If preventing HIV through male circumcision — the single most cost-effective HIV prevention strategy for the hardest hit countries — is too expensive, how can immediate and lifelong treatment for all HIV-positive people be anything but impossible? Either both prevention and treatment options are possible — an epidemiologically sound formula for balancing ounces of prevention and pounds of care — or the end of AIDS will be indefinitely postponed” (5/12).