South Africa plans ahead on how to fight AIDS

A new study has set forth several different plans for South Africa on combating the spread of AIDS. The report gave a couple of options ranging from spending 88 billion dollars to 102 billion dollars. South Africa has more people living with HIV-AIDS within its borders than any other country in the world.

From the Guardian, health writer Sarah Boseley details who compiled the report and its contents.

A major inquiry has now been carried out by the aids2031 South Africa project at the request of the South African government. This is an investigation by the Cape Town-based Centre for Economic Governance and Aids in Africa with the Results for Development Institute from Washington DC. South African government officials sat on the steering committee. Their report paints three different scenarios for South Africa. It's not the good, the bad and the ugly. Nothing is so simple. The options on offer here are dubbed narrow, expanded and hard choices and it takes the long view, examining what shoould happen over the next 20 years.

Essentially, the narrow option is where South Africa's current Aids plan will take it. Between now and 2031, that will cost R658bn, which is US$88bn. The number of new infections will fall, but only gradually, to about 350,000 a year.

The expanded option is ambitious and has greater focus on prevention. Male circumcision programmes would be introduced, but also behavioural change initiatives, to reduce violence against women and empower commercial sex workers. There would also be some initiatives to reduce poverty and an increase in condom distribution and voluntary HIV counselling and testing. The total cost over the 20 years could reach R765bn, or US$102bn, but new infections would fall to less than 200,000 a year.

The hard choices programme envisages the government taking the difficult decision to focus on what works best, at a time of financial austerity. Male circumcision would be rapidly scaled up, but some other interventions, for instance to help orphans and vulnerable children, would be curtailed. It's the cheapest option, at R598bn, or US$79bn, but new infections would still fall to 225,000 a year, the group says.

The expanded scenario is clearly the best. This is what the report says:

"If considerably greater political will and financial resources can be mobilised and the South African society can be motivated to adopt important social and behavioural changes... a powerful change in the epidemic could occur, with lower rates on infection and mortality.

"If the financial resources for HIV/Aids are highly constrained and political backing remains strong but more moderate than under the expanded... scenario, then the more targeted approach under the hard choices is still an attractive alternative to the status quo."