Canning takes time to look at how low income countries go about dealing with the issue of HIV/AIDS. The author’s argument is based on the understanding that any money that is available to fight the disease is often split between prevention and treatment. Therefore, Canning joins other economists in trying to find out which is the most cost-effective way for low-income countries use their budget for HIV/AIDS. Most of the author’s arguments are based on a famous/infamous claim that was made during the 2002 XIV World AIDS Conference, where a group of researchers explicitly stated that it made more economic sense to focus on HIV/AIDS prevention and less so on treatment. Canning’s argument cautions observers against rejecting this point-of-view because a cost effective analysis is still one of the best ways to maximize health benefits.

The author starts his argument by looking at the health, economic, and social burdens of HIV/AIDS. The observation is that HIV/AIDS is one of the main causes of downgraded disability-adjusted life years (DALYs). On matters economy, the article finds no evidence to indicate that HIV/AIDS reduces income per capita. However, the disease has been noted to eat into the GDP of low-income countries. Furthermore, people who feel that their lives have been shortened by disease might not participate fully in their respective economies. The article continues by looking into the epidemiology, prevention, and treatment factors surrounding the disease. The transmission levels of the disease are found to be closely related to the viral load of transmitting partners. The author looks at the available treatment options from an African context. The most valid treatment option is antiretroviral therapy accompanied by professional monitoring by a healthcare professional. The author also finds that focusing on prevention before ARV therapy is likely to lower the number of infections. However, stakeholders should be aware of the inevitability of the “tragic choice” between treatment and prevention. The article concludes by noting that given the current scope of the pandemic, most of the other indicators restate the cost-effectiveness of prioritizing prevention over treatment.

Perspective

The argument that is forwarded by Canning and other like-minded economists is “academically” sound but it fails to put various factors under consideration. Canning argues that low-income countries should prioritize HIV/AIDS prevention instead of treatment. Furthermore, this argument is based on research that indicates that this approach is more cost-effective in the long-term. This problem with this economic-thinking is that it does not take into account that HIV/AIDS is humanitarian issue in low-income countries. For example, for most of the people who are afflicted by the disease any government-organized organized help or charity is their only choice. Therefore, if the government ignores the treatment aspect of the disease, there will be no other option for most of these effected people. Canning’s argument is mainly applicable to the environment in middle and developed economies, where an infected person might have other treatment options available to him/her. However, by neglecting patients in developing and low-income countries, the stakeholders might as well be condemning the affected people. The economics of this decision might also work negatively by reversing the expected impacts. For example, the article points out that those patients with low CD4 counts are more likely to infect others. On the other hand, only ARV treatment helps individuals to achieve low CD4 counts. Therefore, treatment interventions also serve the purpose of lowering the rates of infection. The only way for Canning’s argument to gain low-income country significance is if he advocated for more prevention under local-economy funding while treatment should be taken up by donors and other players from the international community. This approach serves both the economic and humanitarian functions.

 
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