“The rising enthusiasm for providing more medicines threatens to come at the expense of promising initiatives for preventing HIV infections in the first place — initiatives that could save many lives, with less money,” Craig Timberg, the newspaper’s deputy national security editor, and Daniel Halperin, an epidemiologist at the University of North Carolina, write in this Washington Post opinion piece. “Ambitious treatment efforts and smart prevention programs are, of course, not inherently at odds. But especially in an era of fiscal constraint, these two goals could come into conflict,” they write, continuing, “The result, wasteful in dollars spent and lives diminished, would represent only the latest misjudgment by powerful donor nations such as the United States, which still struggle to understand the root causes of an epidemic that has spread most widely in weaker, poorer nations.”

They provide a brief history of the epidemic, discuss its root causes, and explore the politics of prevention funding, writing, “In Africa, the most important cause of the epidemic is sexual cultures in which it’s not unusual for people to have more than one partner in the same week or month.” Timberg and Halperin conclude, “Only recently have Western donors begun focusing on the power of partner reduction to reverse HIV’s spread and supporting local efforts to promote it. … Keeping sexual behavior at the center of the conversation about preventing HIV is essential to reversing the spread of the virus” (3/9).