Ethical challenges in long-term funding for HIV/AIDS

Health Aff (Millwood). Nov-Dec 2009;28(6):1666-76. doi: 10.1377/hlthaff.28.6.1666.


The global response to the AIDS pandemic aims for universal access to treatment and for pursuing every possible avenue to prevention. Skeptics, doubting that the huge increases in current funding levels needed for universal treatment will ever happen, would scale back antiretroviral treatment in favor of more cost-effective preventive interventions. Economics, politics, and science figure in this debate. But there is also a question of ethical principle: Is there a moral imperative to emphasize treatment, even if emphasizing prevention would save more lives? The authors examine moral arguments that address this question, and come down on the side of saving the most lives via prevention.

MeSH terms

  • Acquired Immunodeficiency Syndrome / prevention & control*
  • Acquired Immunodeficiency Syndrome / therapy*
  • Anti-Retroviral Agents / supply & distribution
  • Anti-Retroviral Agents / therapeutic use
  • Bioethical Issues
  • Cost-Benefit Analysis
  • Health Policy*
  • Health Services Accessibility / economics
  • Health Services Accessibility / ethics*
  • Humans
  • Preventive Health Services
  • Research Support as Topic / ethics*
  • United States


  • Anti-Retroviral Agents