10 ways to solve AIDS in Africa

In researching my topical review paper, I stumbled upon this fascinating learning module from the website Clinical Care Options HIV. It's titled "10 Ways to Solve AIDS in Africa" and it goes through the history of HIV/AIDS and specifically case studies in Africa (Malawi). I found one part of it really interesting:

In the few short years I have worked in Africa, there are certain catch phrases that I hear repeatedly by various functionaries in the region. They include sustainability, needs assessment, training, palliative care, and social marketing. These phrases are not necessarily bad ones, but in the context of the global crisis of HIV, they allow the speaker to delay making any actual impact on the epidemic. By preventing programs from being initiated because they might not be sustainable, the funding agency neglects to discuss the issue with the clients. A simple walk to an HIV clinic would get an answer as to whether or not the person with HIV cared whether a program started today might not be there tomorrow. Until President Bush's Emergency Response for AIDS Relief (PEPFAR) program began, most US government donor programs would not pay the salaries of the native personnel. For instance, the United States Agency for International Development (USAID) would pay for training of nurses or a needs assessment as to whether a problem existed or not, but the agency would not pay the salary of a nurse to actually solve the problem. Palliative care, while admirable in a country where there are medications to treat the disease and death results from a failure of such treatment, is obscene in a country where there are no medications. Holding hands and morphine are important but are more expensive than the dollar per day cost of antiretrovirals that would help the client avoid death altogether. Finally, the concept of social marketing is popular in some circles, either with condoms or insecticide-impregnated mosquito nets.[31] Social marketing uses concepts from commercial marketing to plan and implement programs designed to bring about behavior change that will benefit individuals and society. Although there is no question that there is a benefit from such techniques, sometimes this takes the form of putting a nominal charge on an item that the government would like to see used increasingly. The belief is that if a client has to pay for an item, he or she will value it more and will more likely use it. In a country such as Malawi, where income is so low, the success of such techniques is nonexistent. Fewer than 8% of the children actually sleep under a net purchased by their parents under the social marketing program.

(In case you're wondering, these are his ten ways to solve AIDS in Africa:

1. Promote the rights of women

2. Provide testing for all

3. Speak out publicly and personally about HIV infection

4. Eliminate Africa's debt

5. Eliminate corruption

6. Provide access to medications

7. Eliminate brain drain

8. Provide and upgrade infrastructure

9. Revamp systems for providing aid

10. Promote research – consider Africa-specific needs)

Another thing he points out is that Jeffrey Sachs estimates the cost of providing antiretrovirals to everyone throughout the world with advanced stages of AIDS to be $5 billion, while UNDP estimates it to be close to $15 billion. Where is this discrepancy coming from?