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Turning the Tide through Better Prevention: Mead Over on the AIDS Transition
May 25, 2010
Even as the cost of treating HIV/AIDS has fallen dramatically, the number of people newly infected has remained high. What can be done to reverse this trend and finally defeat this disease? This week on the Wonkcast, I’m joined by Mead Over, a senior fellow here at the Center for Global Development and perhaps the world’s leading expert on the economics of HIV/AIDS. He has recently published two major essays, which introduce the concept of the “AIDS transition”—the point in time where the number of people living with the disease begins to fall. He argues persuasively that to reach this point, international donors must greatly strengthen incentives for effective prevention.
“Just adopting a new paradigm, by itself, is no magic bullet for the AIDS epidemic. The litmus test of the paradigm will be whether it enables policymakers at every level… to integrate the twin goals of reducing mortality through sustained access to treatment and better preventing new infections… Only programs that work on both—and can show results on both—should be eligible for funding.”
-Mead Over, from “The Global AIDS Transition”
Read the Essays
“We should be very proud of the accomplishment in bringing down the numbers of AIDS deaths,” says Mead. “But the number of new infections… has not fallen enough. And so the result is we have a new take-off in the numbers of people living with AIDS.” Since 1997, he says, the number of HIV-infected people has increased by 50%, rising from around 22 million in 1997 to 33 million today.
Listen to the podcast to hear Mead explain the concept of an AIDS transition, and how donors can greatly strengthen prevention efforts, including through innovative links between prevention and treatment. For more, read Mead’s two essays (a third, on treatment, will be published in June) that explain in depth the powerful, persuasive, yet potentially controversial new paradigm Mead proposes:
- The first essay explains the concept of the AIDS transition and makes the case for better prevention—a 10% decline in new infections, says Mead, could save $113 billion dollars in treatment costs by 2050.
- The second essay examines the research on HIV prevention and lays out specific ways that using performance-based incentives could decrease the rate of new HIV infections, including a discussion of how the Cash on Delivery Aid approach might be applied to HIV prevention.
- The third essay presents original estimates of the magnitude of the future fiscal burden of AIDS treatment under alternative assumptions about treatment quality and scale up and proposes policy options to harmonize the incentives among donors, recipient governments, and AIDS patients to sustain treatment quality while leveraging treatment demand for the prevention of future cases.
Have something to add to our discussion? Ideas for future interviews? Post a comment below, or send me an email. If you use iTunes, you can subscribe to get new episodes delivered straight to your computer every week.
My thanks to Wren Elhai for his very able production assistance on the Wonkcast recording and for a draft version of this blog post.
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2 Responses to “Turning the Tide through Better Prevention: Mead Over on the AIDS Transition”
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November 12th, 2010 at 4:29 am
Thanks for the interesting news but I think that the best way to deal with AIDS pandemic is to integrate services and I can give you an example of how Rwanda (East Africa) has achieved good results through integrated services: The mother to child transmission of HIV/AIDS in the country reduced by 8.3 percent from 11 percent in 2004 to 2.7 percent by the end of last year and this is attributed to the downward trend to attention given to HIV positive pregnant women.We have reduced weeks of HIV/AIDS infected pregnant women when they start accessing drugs from 28 weeks to 14 weeks to effectively combat the virus from being transmitted to unborn babies,”
Still to come.
Dr NKEZABERA Emmanuel
In Charge of Pediatric HIV Practical Trainings
November 12th, 2010 at 4:19 pm
Thanks Dr. NKEZABERA, for your comment. I agree that service integration can also help improve the efficiency of service delivery. I’m glad it has worked out so well for you. The Cash-on-Delivery idea is designed to give the leaders at the TOP of government the incentive to do whatever it takes to assure improved service delivery. If Rwanda had a COD program for HIV prevention, people like you who are champions of efficiency high-quality HIV prevention service delivery on the ground, would find more allies to help you achieve your goals throughout the country.