The HIV Trade-Off

Karl Barth’s prescription for an engaged Christian is often quoted: Keep in one hand the Bible and in the other hand the daily newspaper. I tweak the advice of the famed Swiss theologian for my own discipline and keep in my newspaper hand copies of two highly regarded dailies: The Wall Street Journal and The New York Times. Most folks read the news that reinforces their own point of view. Absorbing a steady diet of adversarial positions and the statistics that accompany them helps us to identify those idols closest to home.

That’s also why I keep up a subscription to Forbes, the magazine that proudly touts itself as a publication for “the world’s business leaders.” I was leafing through a copy of Forbes recently, and an article caught my eye: “Treating HIV Doesn’t Pay.” The tagline was equally jarring: “It is humane to pay for AIDS drugs in Africa, but it isn’t economical. The same dollars spent on prevention would save more lives.”

The piece penned by Emily Oster, a graduate student of economics at Harvard, applies an economic cost-benefit analysis to a serious social crisis. She pits pouring resources into antiretroviral therapy that may save individual lives against a preventative strategy that would arrest the spread of the epidemic.

Oster does a yeoman’s service by dispelling a widely held myth that AIDS has spread in Africa primarily due to the undisciplined exercise of libido—in simple terms, the idea that Africans have more sex and more sexual partners. While sexual behavior certainly plays into the AIDS epidemic in Africa (as it does everywhere), Oster points out that its transmission can be traced in large part to untreated infections such as gonorrhea and syphilis that create open sores and serve as a hotbed for HIV.

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Sojourners Magazine February 2006
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