Reading for 11/18

The article “AIDS Care and Treatment in Sub-Saharan Africa: Implementation Ethics” by Stuart Rennie and Freida Behets points out the numerous conflicting issues that come in contact when determining how resources for fighting the AIDS pandemic should be allocated. Since there is a very limited amount of funding and treatment available for AIDS, there must be short term rationing. I was very shocked by Figure 1, the table with the estimated number of people needing treatment, the number on treatment, and the percentage covered. With the amount of funding that has gone into AIDS, I expected the percentages to be much higher. Due to the lack of available treatment, the treatment has to be rationed, but there are questions as to how this can be done. For instance, if everyone should be treated equally, then the people who are the most in need of treatment will have equal chances of receiving treatment compared to the people who may not need treatment so urgently. In a sense, this is also an unfair method of rationing AIDS treatment because some would argue that treatment should go to those who are most in need, just like a progressive tax rate is often used over a flat tax. In addition, there is controversy surrounding what the funds should be used for. PEPFAR was controversial because it went to fifteen seemingly arbitrary countries that may not have been most desperate for AIDS funding but perhaps the countries whose political beliefs were more aligned with the United States. It was also controversial because a large part of the fund was used for contraception and counseling for abstinence instead of for AIDS treatment. Some countries did not use the funds wisely to fight the AIDS epidemic, which leads to another problem of whether or not the people who are donating money should be able to dictate where the money goes and to what extent they should have control over how money is spent. Since funding is so limited, there are issues concerning what exactly the funding should be used for, whether to improve infrastructure, food so that AIDS treatment is more effective, or treatment and who qualifies for those treatment. I thought this article was interesting because it highlights the numerous problems that arise when we are trying to eliminate the AIDS epidemic. It brings up the different types of issues that must be considered when using and allocating limited funds for AIDS, and how different countries in sub-Saharan Africa have responded or can possibly respond to them.