Mapping Pathways is a multi-national project to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of antiretroviral-based prevention strategies to end the HIV/AIDS epidemic. The evidence base is more than results from clinical trials - it must include stakeholder and community perspectives as well.

20 March 2012

The World Bank Reports the Need for Greater HIV Prevention Measures in Africa


A patient suffering from HIV is taken to a local hospital in Harare, January 31, 2012. The World Bank says significantly better HIV prevention efforts are needed in Africa. It says a slow global economy and uncertain donor aid make preventing new infections a necessity.

A new World Bank report says the world’s economic woes are causing “anxiety about maintaining and expanding AIDS treatment programs in low income countries.”

Co-author Elizabeth Lule said concerns about tight budgets coincide with much progress being made against the disease.

“HIV prevalence, especially among young people, is going down in southern Africa. In countries where there’s highest burden, young people have better knowledge. They’re using condoms consistently. They’re reducing partners. So there is a lot of progress,” she said.

Also in recent years, studies have shown that giving antiretroviral drugs to HIV negative people can protect them from becoming infected. And there’s been progress in vaccine research, although an effective vaccine is still considered years away.

Fiscal dimension

“We shouldn’t just be looking at HIV/AIDS as a health problem, but also as an economic problem because of the huge costs that are incurred in treating people as well as prevention. And we highlight the importance of continuing to use effective prevention in order to contain future costs,” she said.

The report is called The Fiscal Dimension of HIV/AIDS in Botswana, South Africa, Swaziland and Uganda.

“There’s been very limited analysis on the fiscal dimension of HIV/AIDS for countries to understand the future liability that they take on, especially if they do not reduce new infections. They would only be adding to the burden,” she said.

Lule, the World Bank’s acting director for regional integration in Africa, said treating HIV/AIDS can only be done on a long term basis.

“When a person gets HIV/AIDS it usually takes a number of years before they develop full-blown AIDS. But then once you put them on treatment you cannot stop. And they may survive, of course, for a long time and the countries have to incur those costs. And then the more new infections you have the more people you have to treat in the future. And therefore the higher costs that countries would have to incur,” she said.

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