Emerging Issues in Today's HIV Response Debate Series
Debate One: Test and Treat: Can We Treat Our Way Out of the HIV Epidemic?
The first debate in the USAID and World Bank-sponsored Emerging Issues in Today’s HIV Response Debate Series was based on the following proposition: “Testing and treating approaches should immediately be built into and consume at least 50 percent of HIV prevention resources in Africa.” The debate was prompted, in part, by a 2009 article by Reuben Granich and others in The Lancet that suggests an annual and universal test and treat strategy, in which individuals who test positive (as a result of annual compulsory testing of the entire population) would immediately receive antiretroviral treatment (ART) regardless of CD4 cell count. Using mathematical modeling and data from South Africa, the paper postulated that the number of HIV cases could be reduced to 1 per 1,000 people per year within a decade, leading to eventual elimination of the epidemic.
Dr. Ward Cates, President for Research at FHI, moderated the debate. Two panelists spoke in favor of the proposition: Dr. Julio Montaner, Chair in AIDS Research and head of the Division of AIDS at the Faculty of Medicine of the University of British Columbia, and Dr. Peter Kilmarx, Chief of the Epidemiology Branch in the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention (CDC), Atlanta. The two panelists who spoke against the proposition were Dr. Norman Hearst, Director of Family Medicine Research Fellowship at the University of California at San Francisco, and Professor Sally Blower, Director of the Center for Biomedical Modeling and Professor in the David Geffen School of Medicine at the University of California Los Angeles.
Download the Summary Report (PDF, 183 KB) to read more.
- Flyer for Debate 1 (JPG, 269 KB)
- Prevention Knowledge Base: Combination Approaches
Combining mutually reinforcing biomedical, behavioral, and structural interventions to build a comprehensive, lasting, and effective response to HIV
- Prevention Knowledge Base: Behavioral Interventions
Strategies that promote safer behaviors to prevent HIV
- Prevention Knowledge Base: Structural Interventions
Efforts to address social, political, and economic factors that increase vulnerability to HIV