Wednesday, August 17, 2011
Here's another interesting post about PrEP from Joseph Sonnabend's blog. In addition to the iPrEx trial showing a very small absolute risk reduction for Truvada, the cost of preventing one HIV infection is also massive. Sonnabend's estimate is about half a million dollars.
Even at a fraction of that cost, it seems unlikely that any high HIV prevalence country could afford PrEP. Nor are any donors likely to be in a hurry to finance a large PrEP program.
But there are a couple of other worries expressed: PrEP will only be appropriate for a small number of people, and they are mostly living in rich countries. And HIV prevention as a whole is in danger of being thrown off course by the euphoria about PrEP. Money which should be going to education could be diverted to drugs which are expensive and of very limited use.
People still need to be aware of the risks of being infected with HIV and of what they can do to avoid it. Spending all prevention funds on PrEP will not have the impact being claimed by the HIV drug industry.
Here in East Africa, there has been so much discussion about people's rights over the years, how those rights have been denied and how this relates to HIV transmission. Are their rights now so worthless that they can be replaced with some overpriced drugs that don't even work very well?