HIV treatment in developing countries makes economic sense

PARIS -- A leading economist on Sunday dismissed arguments that treating HIV in developing countries is not cost-effective and increases the virus' resistance, saying it is more expensive not to treat the virus that causes AIDS.

Jean-Paul Moatti, an authority on the economics of AIDS, told scientists at the opening of an international AIDS conference there is growing evidence it is economic "stupidity" not to deliver treatment to the developing world.

Specialists estimate that only about 5 percent of the 30 million people in poor countries who need treatment for HIV infection are getting it.

Moatti said the prices of HIV drugs have come down and can be lowered further to make treatment in developing countries feasible.

Moatti also said studies show that resistance to treatment is no more common in the developing world than elsewhere and recent evidence has shown that treatment enhances prevention efforts, rather than hampering them.

"We have systematically underestimated the impact of AIDS on the economy," said Moatti, an economics professor at the University of Marseille in France.

"It doesn't just kill workers, it kills young adults and young adults make children and raise children -- human capital. When you take that into the equation, you find a very different impact on the economy."

Moatti cited an upcoming World Bank study that he said predicts an economic collapse in South Africa within four generations if nothing is done to treat HIV. South Africa has the highest number of infections in Africa -- 5 million.

"South Africa will be taken back to the level of Kenya. It's GDP (gross domestic product) will be divided in two. It will no longer be a middle-income country," Moatti said.

Dr. Joep Lange, who is president of the International AIDS Society and was not connected with Moatti's report, said the evidence "dispels the economic myth" that has kept people from scaling up access to HIV care in developing countries.

Many experts, including economists, historically have argued that improving access to treatment in the developing world would increase resistance to the drugs and encourage people to engage in risky behavior. Others believe the funds needed to provide treatment would be better spent on prevention efforts.

Former Brazilian President Fernando Henrique Cardoso also discussed at the conference his country's success in providing antiretroviral treatment for all needing it. Experts say the experience in Brazil indicates that universal treatment is possible in any country.

"There is this economic rationale now. This is new. Three years ago people were still thinking that we should go to prevention rather than treatment," said Dr. Michel Kazatchkine, director of France's AIDS research agency. "Every day that we don't start to scale up is going to cost us more."

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