The New Scientist Thinks We Can End AIDS in One Generation But I Don't

(photo credit: Sully Pixel)

The New Scientist recently proposed a plan to end AIDS in the world. Basically, get everyone in the world to take ARVs, and push their viral load down to undetectable levels. Undetectable viral levels are not transmitted through sexual contact. No one new is therefore infected. Once the current generation of HIV-infected individuals reaches the end of their lives, your problem is over.

I realize that they meant this as a think piece, and the article and editorial are well worth reading. They’ve got some interesting information on treatment specifics with regard to CD4 levels, new hope for cures, and research on the sexual transmission of HIV.

But wow – way to oversimplify a complicated problem and propose an unbelievably bad solution. They allude to some of the huge problems with this plan in the article, “Persuading everyone with HIV to start therapy purely for public health reasons could be ethically dubious. To identify everyone who is HIV positive would require such widespread testing that some may feel it breached their civil liberties. Then there is the question of who would fund such a massive undertaking.” But that doesn’t even begin to touch the problems with this idea.

First of all, sexual transmission is not the only way a person can get HIV. In some parts of the world, like the former Soviet Union, HIV is transmitted primarily through sharing dirty needles. An undetectable viral load doesn’t eliminate that mode of transmission. We’ve seen HIV transmission in health care settings due to bad infection control, and outbreaks in China because of blood collection practices.

Not to mention that getting ARVs to everybody with AIDS runs much deeper than a funding problem. You need health care providers who can prescribe and manage treatment regimens, and a logistics system that will get the drugs to the places that need them. None of this could be solved overnight with a cash infusion. You need training, and that takes time. There’s no way around it.

I also take issue with the New Scientist article in general. It’s a little to prone to rely on hype and generalizations. I really don’t think that “in the west [HIV] is still seen as affecting mainly gay men, immigrants, prostitutes and drug addicts.” And I dislike the focus on “abroad” as a reservoir of HIV.