Choosing our battles: Why fight HIV?
HIV and AIDS are terrible. They’re particularly terrible if you’re living in a country where anti-retrovirals are not available, and I don’t want to appear to trivialise that. But worldwide, the bigger estimates state that only 38 million people have HIV. That’s less than two-thirds of the UK population. Given that we have a very limited pot of money to tackle health problems in the developing world, is HIV the best thing to tackle?
Many people like to try and wage war with HIV on the basis that it’s easy to prevent. It’s said that consulting your sexually transmitted disease doctor, practicing safe sex, or abstinence, prevents HIV infection. That’s true. But that doesn’t make it easy to tackle. Even in the most developed and scientific of nations, we can’t get the safe sex message across. The UK has an appallingly high rate of teenage pregnancy, sexually transmitted infections, and sexually-transmitted HIV. Over 50,000 people in the UK are HIV positive, and that number is growing by almost 7,000 per year. We’re much better placed to tackle HIV than are aid workers with limited resources in Africa, not least because this country has a much lesser objection to the use of barrier contraception. Tackling HIV is not easy.
Treating HIV is vastly expensive. Conservative estimates say that anti-retroviral treatments cost a minimum of US$3,600 per year. Providing anti-retrovirals does not cure HIV, it merely slows its progress. And looking at things in a cruelly scientific way, the longer an HIV positive person is alive, the greater the risk of infecting a greater number of people. I’m not condoning murder of all HIV positive people in Sub-Saharan Africa, and it’s not an entirely sensible way of looking at things, but it’s an opinion held by many.
On the other hand, malaria affects 500 million people per year, and is easily and cheaply preventable. Yet 20% of child deaths in Sub-Saharan Africa are due to malaria. A child dies every of malaria every thirty seconds. 95.2% of malaria infections can be prevented with a US$5 mosquito net impregnated with insecticide, which is effective for 5 years. In many test villages, malaria was eradicated by these nets. For the same cost as treating one person with HIV for one year, 720 nets can be bought. For the cost of the cheapest anti-retroviral treatment for every HIV suffer for a year, over 14 billion of these nets could be bought – malaria could be virtually eradicated.
Malaria is, by no means, a death sentence. Treatment is cheap – US$0.90 for a child, US$2.40 for an adult. But with so many infections, the cost soon adds up. So to claim that malaria is not worth preventing because it’s cheaply treatable is inaccurate, and really makes little sense.
Malaria isn’t as perversely marketable as HIV. It’s not a taboo subject, and it gets little press because it affects the poorest of the poor, not the richer parts of African society. Think: When was the last time you heard the phrase “Millions dying of HIV in Africa”? When was the last time you heard of “Millions dying of malaria in Africa”? Fewer die of malaria than HIV; but we could feasibly eradicate malaria right here, right now. Why don’t we?
People with HIV and the scores of other infections which kill Africans should not be left to die. We have to do something, and we have to start somewhere. Why not with malaria?
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