Turning the Tide Through Better Prevention: Mead Over on the AIDS Transition

EDITOR’S NOTE:  Reaching AIDS transition - the point in time where the number of AIDS-infected people starts declining - entails strengthening donor incentives for effective prevention, according to Mead Over, senior fellow at the Center for Global Development. Over speaks with CGD colleague Lawrence MacDonald to further discuss the concept of AIDS transition.

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.

 “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.

Re-published with permission by the Center for Global Development. Visit the original article.

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