About $16 billion a year is spent on AIDS in poor and middle-income countries. Half is generated locally and half is foreign aid. A report in this week’s Lancet suggests a carefully crafted mixture of approaches that does not involve treating all those without symptoms would bring great benefit for not much more than this—a peak of $22 billion in 2015, and a fall thereafter. Moreover, most of the extra spending would be offset by savings on the treatment of those who would have been infected, but were not—some 12m people, if the boffins have done their sums right. At $500 per person per year, the benefits would far outweigh the costs in purely economic terms.
The drugs used to treat AIDS may also stop its transmission. If that proves true, the drugs could achieve much of what a vaccine would. An extra 40% in spending for the next 5 to 10 years could stop the transmission AIDS and then enable the disease to be fought more cheaply than what is currently done.