AN EPIDEMIOLOGIST believes he could stop the spread of HIV within five years and possibly wipe it out within 40 or 50 years.
This could be accomplished without the development of a vaccine against the Aids virus, he argues.
“Maybe it is a bit optimistic, but we face Armageddon,” stated Dr Brian Williams of the South African Centre for Epidemiological Modelling and Analysis (Sacema) in Stellenbosch, South Africa.
He has been battling against HIV for years and put his case over the weekend to the American Association for the Advancement of Science (AAAS) annual meeting under way in San Diego. “The HIV epidemic is one of the worst plagues” that the world has ever encountered, he stated. “South Africa is extraordinarily badly affected by the epidemic.”
He described working in a clinic he ran outside Soweto several years ago. He found that 85 per cent of women under 25 coming into the clinic tested HIV positive.
Anti-retroviral drug treatments are effective for holding the virus at bay, but no vaccine has yet emerged to halt the disease. “We have stopped people dying, but we have not stopped the epidemic.” Drugs available today are able to make a HIV-positive person 25 times less infectious. “Can we use anti-retroviral drugs to keep people alive but also stop transmission? I believe we can,” Dr Williams said.
He advocates the introduction of mass HIV screening in areas heavily affected by the virus, followed by immediate administration of anti-retroviral treatment to reduce virus transmission. Even achieving a 70 per cent pick-up of infected individuals should be enough to reduce transmission dramatically, he said.
Transmission and mortality could drop by up to 95 per cent with such a programme, and it could be accomplished in as little as five years, be believes. The drugs, in conjunction with education about HIV infection, would allow HIV-positive people to lead normal lives, helping to keep transmission to a minimum.
As their natural deaths occurred, the overall number of people carrying the virus – and hence the risk of HIV spread – would decline over time in four to five decades. “We really are in it for the long term,” Dr Williams said.
He acknowledges that the programme would be expensive, perhaps costing $3-$4 billion in South Africa alone. Yet cost savings would be made “from day one” in helping to reduce premature deaths among the younger population, and the extended medical care needed in the absence of drug treatment. “The only thing more expensive than doing this is not doing this,” he suggested.
There had been considerable interest in the idea and groups in the US, Canada and Europe are looking at pilot programmes to test it.
Dr Williams said a trial was likely to begin soon in Hlabisa, a village 700km north of Durban.
