Abstract:
There are two approaches to reducing the burden of sickness and death associated with HIV/AIDS: treatment and prevention. With limited resources, should the focus be on prevention or treatment? I discuss the range of prevention and treatment alternatives, examine their cost effectiveness, and consider various arguments that have been raised against the use of cost-effectiveness analysis in setting priorities for health. I conclude that promoting AIDS treatment using antiretrovirals in resource-constrained countries comes at a huge cost in terms of avoidable deaths that could be prevented through interventions that would substantially lower the scale of the epidemic.