Scaling Up AIDS Treatment: What Is the Potential Impact and What Are the Risks?

0102 There has been a recent and dramatic rise in global funding for HIV/AIDS, from US$2.1 billion in 2001 to US$6.1 billion in 2004 [1], thanks to several new funding mechanisms (Box 1). These funds, coupled with reduced drug costs, make it feasible to roll out antiretroviral therapy (ART) even in resource-poor settings. Nevertheless, the total number of people living with HIV rose in 2004 to reach its highest level ever: an estimated 39.4 million people are living with the virus, including 4.9 million who acquired it in 2004 [1]. Therefore, the debate over the appropriate distribution of money between prevention efforts (such as voluntary counseling and testing [VCT], or behavior change) and treatment efforts (the provision of ART) is now more topical than ever.