'Train sex workers against Aids'
2001-12-12 23:17
Ouagadougou - Providing HIV awareness counselling to prostitutes is more than 2 000 times more cost-effective as a life-saver in Africa than treating Aids victims with anti-retroviral drugs, researchers said on Wednesday.
Advising urban sex workers on risky practices and giving them
condoms so that they do not spread the virus costs just $1.32 per year per life saved, according to a team from Institute
for Human Development at the University of California at Berkeley.
By comparison, administering the cocktail of anti-retroviral
drugs to extend the lives of people who already have the virus
costs around $3 800 per year per life saved.
Even if cheaper generic anti-retroviral drugs are used, rather
than costlier patented equivalent ones, the bill from treatment is
still very high.
Giving generics that would cost less than 40% of current
patented prices would still cost $3 016 per life-year saved.
This is because of the high fixed costs of drug administration,
such as having qualified medical personnel to monitor patients'
progress, which cannot be eliminated however cheap the medication.
The study, presented here at a major conference on Aids in
Africa, drives at the heart of the problem of how to get the best
value for money from slender resources in the fight against the
pandemic.
Emiko Masaki, a Japanese researcher at Berkeley who made the
presentation, said the figures were emphatic proof that precious
dollars should be focussed far more on preventing Aids rather than
treating it.
"Treatment and preventing are competing for the same funds," she said. "But resource allocation decisions affect the number of lives
saved. Prevention should take a higher priority over treatment."
Among medications, the most cost-effective is nevirapine, when
given to pregnant mothers to prevent them from handing on the virus
to their babies.
That costs $11 per life-year saved.
Other highly cost-effective ways of stretching the anti-Aids
dollar include encouraging people to undergo blood tests for the
virus and providing them counselling on safe sex. These cost
between $22 and $30 per life-year saved.
The research is based on a comparison of seven previous studies
on HIV prevention and treatment in sub-Saharan Africa, and the
team's own estimates of drug costs. - Sapa-AFP
- SAPA