Treatment of AIDS Will Require Targeting the Regions and Populations Most Affected

By Michael Gerson | DECEMBER 1, 2014

My college roommate — the most immediately likable person I’ve ever met, a man who would now be such a present to the world — died of AIDS at the age of 30. Back then, people with the disease did not so much die as fade, becoming gaunt and ghostly images of themselves, as the virus gradually destroyed enough T-cells to cut their ties with the flesh. Metaphors don’t really capture the horror. Declined? Withered? At any rate, he died.

That was 20 World AIDS Days ago, shortly before the arrival of miracle drugs that could have saved my friend’s life. Several years later, when I was on the White House staff, the existence of those medicines created a moral predicament. While antiretroviral drugs were broadly available in the developed world, they were rarely distributed elsewhere. Of about 30 million people with HIV in sub-Saharan Africa, perhaps 50,000 were in treatment. The pandemic had already produced millions of orphans. Walking through South African shantytowns, I mainly met grandmothers and their grandchildren. The intervening generation was nearly erased. In the most affected countries, life expectancy had fallen by 20 years.

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