THE global Aids epidemic could be contained within five years by testing everybody in high-risk regions and immediately treating all those who are found to be HIV-positive, according to a leading scientist.
Universal therapy with anti-retroviral drugs would not only save millions of lives but would also prevent transmission of HIV by making people who carry the virus less infectious, said Dr Brian Williams, of the South African Centre for Epidemiological Modelling and Analysis.
While such an initiative would be expensive at first, costing at least $3billion (R23,1billion) a year in South Africa alone, it would pay for itself by cutting the cost of care and reducing the economic damage caused by Aids deaths, Williams told the American Association for the Advancement of Science conference in San Diego.
In the absence of a vaccine, an aggressive treatment programme is the first promising way of controlling a condition that affects 33million people worldwide and kills 2,1million every year, he said. It also has the potential to halve tuberculosis infections associated with HIV and Aids.
Two randomised trials of universal testing and treatment are to begin in South Africa shortly, and the World Health Organisation has indicated that it will back the strategy if they prove successful.
The approach is also supported by Anthony Fauci, the influential scientist who leads the US National Institute on Allergy and Infectious Diseases, which is funding further trials in areas of Washington DC and New York, where HIV is widespread.
Williams, a former WHO epidemiologist who still advises the UN body, said: "The question is: can we use ARVs not only to keep people alive but also to stop transmission? I believe that we can. I believe that if we use them effectively we could stop transmission within five years."
Antiretroviral drugs are so effective at containing HIV that deaths are becoming increasingly rare in developed countries where patients have good access to them. Only about 12percent of HIV-positive people worldwide are taking the drugs, however.
The drugs also reduce the concentration of HIV in patients' blood, making them about 25 times less likely to infect others through unprotected sex.
Williams said projects in Kenya, Botswana and Malawi had shown that regular testing and compliance are achievable in Africa. "Compliance in Africa is actually much better than in developed countries, because in the latter HIV tends to affect intravenous drug users and other marginalised groups, whereas the victims in Africa are just poor," he said. - The Times News Service, London