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Originally published in Science Express on 2 February 2006
Science 10 March 2006:
Vol. 311. no. 5766, pp. 1474 - 1476
DOI: 10.1126/science.1121176
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Reports

The Global Impact of Scaling Up HIV/AIDS Prevention Programs in Low- and Middle-Income Countries

John Stover,1 Stefano Bertozzi,2 Juan-Pablo Gutierrez,2 Neff Walker,3 Karen A. Stanecki,4 Robert Greener,4 Eleanor Gouws,4 Catherine Hankins,4 Geoff P. Garnett,5 Joshua A. Salomon,6 J. Ties Boerma,7 Paul De Lay,4 Peter D. Ghys4*

A strong, global commitment to expanded prevention programs targeted at sexual transmission and transmission among injecting drug users, started now, could avert 28 million new HIV infections between 2005 and 2015. This figure is more than half of the new infections that might otherwise occur during that period in 125 low- and middle-income countries. Although preventing these new infections would require investing about U.S.$122 billion over this period, it would reduce future needs for treatment and care. Our analysis suggests that it will cost about U.S.$3900 to prevent each new infection, but that this will produce a savings of U.S.$4700 in forgone treatment and care costs. Thus, greater spending on prevention now would not only prevent more than half the new infections that would occur from 2005 to 2015 but would actually produce a net financial saving as future costs for treatment and care are averted.

1 Futures Group/Constella, Glastonbury, CT 06033, USA.
2 National Institute of Public Health (INSP), Cuernavaca 62508, and Centro de Investigación y Docencia Económicas (CIDE), Mexico City 01210, Mexico.
3 United Nations Children's Fund (UNICEF), New York, NY 10017, USA.
4 Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva CH-1211, Switzerland.
5 Imperial College, London SW7 2AZ, UK.
6 Harvard University, Boston, MA 02138, USA.
7 World Health Organization, 1211 Geneva 27, Switzerland.

* To whom correspondence should be addressed. E-mail: ghysp{at}unaids.org

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