Global AIDS Bill Funding Should Target Treatment in Addition to Prevention Efforts, Science Editorial Says

When confronting an epidemic, prevention should be the first concern but, in the case of the global AIDS epidemic, there is serious need for treatment as well, Donald Kennedy, the editor-in-chief of Science, writes in an editorial in the May 16 issue of Science. Due to the fractured nature of health care systems throughout Africa, it is "uncertain how developed nations can best support the capacity" of these systems to confront the AIDS epidemic, the editorial says. Due to the legacy of apartheid, the South African health care system is dominated by white health care workers who are trained in traditionally black regions but who then practice medicine in "nicer neighborhoods," leaving the 20% of South Africans who are HIV-positive largely without care, the editorial says. This lack of palliative care coupled with the scarce availability of antiretroviral drugs has left a "huge and unmet need" in the country, the editorial adds. Therefore, while "prevention may deserve first claim on the new money" in the global AIDS bill (HR 1298), which has passed both the House and the Senate, there is "much need" for funding for treatment as well, the editorial concludes (Kennedy, Science, 5/16).