Have we treated AIDS too well? Rationing and the future of AIDS exceptionalism

Ann Intern Med. 1998 May 1;128(9):756-9. doi: 10.7326/0003-4819-128-9-199805010-00009.


During the past decade, medical therapy for AIDS has become more effective but also prohibitively expensive. A medical tragedy has been transformed into a financial crisis, and society has responded by establishing special programs and sources of funding for AIDS. These maneuvers parallel earlier approaches to HIV testing and reporting that have collectively come to be known as 'exceptionalism.' This paper suggests that exceptionalism in resource allocation is a fragile, short-term solution. In the long run, AIDS exceptionalism will create growing injustice and should be avoided. However, we should not eliminate the advances that this exceptionalism has already achieved. Instead, we need a working dialogue between these advances and public policy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / economics*
  • Acquired Immunodeficiency Syndrome / therapy*
  • Biomedical Research
  • Financing, Government*
  • Forecasting
  • Health Care Costs / trends*
  • Health Care Rationing / economics*
  • Health Care Rationing / trends
  • Humans
  • Resource Allocation*
  • United States