Scaling Up Treatment — Why We Can't Wait

Many arguments have been raised over the years to justify not moving rapidly forward with antiretroviral treatment programs for people living with the human immunodeficiency virus (HIV) and AIDS in settings with limited resources. The standard litany included the price of therapy as compared with the poverty of the patient, the complexity of the intervention, the lack of infrastructure for laboratory monitoring, and the staggering lack of trained health care providers. Narrow cost-effectiveness arguments have been commonplace. False dichotomies — prevention or treatment, rather than both — have too often gone unchallenged. Perhaps of greatest concern several years ago was . . .