JOHANNESBURG – Reversing South Africa's AIDS epidemic may be impossible but there is reason for hope, a researcher who has mapped the cost of controlling the epidemic said in an interview.
The nation of almost 50 million has more people than any other country with the virus that causes AIDS — an estimated 5.7 million HIV-positive citizens. About 500,000 more people become infected each year.
A report released Friday that Robert Hecht helped prepare concludes that reversing the epidemic is "extremely difficult, if not impossible, in the coming years."
In an interview, Hecht said the report's intention is not to discourage but to inspire policy makers to make the right decisions now.
"In order to act and to change the situation, you need to face head-on how serious it is," Hecht said.
Hecht's team concluded that under South Africa's current plan to combat AIDS, $88 billion will be spent over the next two decades, with the number of new infections falling gradually to about 350,000 per year. The team outlines a more ambitious plan that would cost $102 billion over the same period, and bring the number of new infections down to under 200,000 a year.
Mark Blecher, an official in the government's finance department who worked on the report, said it provided important guidance for the government, which has been steadily increasing its AIDS spending in recent years.
"It's very clear that both prevention and treatment need to be scaled up," Blecher said.
Hecht said key steps to reduce the spread of AIDS include male circumcision on a broad scale. That could be a problem in South Africa, where the Zulus, the largest ethnic group, do not embrace circumcision. South African government health officials say they are still studying how to incorporate circumcision into their AIDS policy.
Studies that have shown HIV infection rates were cut by 60 percent among men who were circumcised prompted the World Health Organization to include circumcision in its prevention policies, as long as those who receive the procedure are also counseled to take other precautions, including using condoms.
Hecht, of the Washington-based Results for Development Institute, experts from Cape Town's Centre for Economic Governance and AIDS in Africa and London's Imperial College worked with South African health and finance officials to prepare the report. It was requested by the South African government as it reviews progress since an AIDS turnaround strategy, including a massive testing and treatment campaign, was announced almost a year ago.
Hecht and his fellow researchers estimate South Africa will need to at least double spending by 2016, from around $2 billion in 2009, even as doubts emerge over whether international donors can sustain contributions.
This year, donors committed $11.7 billion to The Global Fund that tackles AIDS, tuberculosis and malaria, a major source of AIDS funds, over the next three years. That was 20 percent more than was pledged for 2008-2010, but far below the $17 billion the United Nations says is needed.