Over the past few months, a radical idea to eradicate AIDS has been floating around in medical journals. No, it's not a cure. No, it won't be fast or cheap. But it is possible, over the next fifty years or so, to eliminate AIDS from the face of the earth.
Do we want to do it?
A good summary of the plan can be found in New Scientist this month, building on studies published in The Lancet.
The key point is this: an HIV-positive person who is on anti-retroviral treatment (ART, the "three-drug cocktail") has an almost zero chance of spreading the virus to a sex partner, even with unprotected sex. The odds are so low that the Swiss government officially calls it zero.
That means that a combination of universal HIV testing (which we don't do now) combined with immediate ART for those who test positive (which we also don't do now -- we wait until their immune systems are compromised) would effectively end HIV transmission. At that point, it's just a matter of waiting until all HIV-positives die from other causes.
The recent Lancet study modeled the cost of such a program for South Africa, which has one of the highest infection rates in the world. The cost would be $3.5 billion per year, or a total of $85 billion over 50-year lifetime of the program. (Costs are higher initially because over time the infection rate declines.) The US population is roughly six times that of South Africa, so you can do the math.
So how about it, kossacks? Is $20 billion a year worth it to eliminate AIDS in the US? Sure, it won't really be effective unless it's worldwide in scope -- there is always the possibility of persons catching the virus while having sex abroad, for example. But we could make a big dent.