HIV / AIDS epidemiology. Authors reply [letter]

This article presents the reply of Evan Wood and colleagues with regard to the arguments raised by Charles Todd. Although the authors acknowledge that AIDS in Africa is a complex problem that requires a widespread campaign addressing socioeconomic issues they believe that to move policy-makers frequently requires research that focuses on individual features of a complicated problem. In the argument that it is obvious that widespread access to triple-combination therapy would improve life expectancy Wood explains that they did not merely intend to qualify the potential benefits of treatment. Rather they sought to assess to what extent price reductions would make antiretroviral treatment accessible to infected people in Africa. In terms of the point that the costs associated with the voluntary testing and counseling that should accompany a prophylaxis program was not modeled Wood presents a two-fold explanation. First that the cost effectiveness of voluntary testing and counseling has already been shown and second that in-country expenditures on these programs are likely to have a beneficial effect in addressing the root causes of the epidemic. Moreover Wood argues that that they referred to sub-Saharan in the title of their paper because the benefits of prophylaxis are probably generalizable to all HIV-1-endemic nations in the region.