Prevention and medication of HIV/AIDS: the case of Botswana

Governments in developing countries are spending more and more money on antiretroviral medication programs in hope that the programs curb the spread of HIV/AIDS and reduce the suffering of those infected. This makes the question of determining the optimal mix of prevention and medication ever more pressing. We construct and parameterize a model of the spread of HIV/AIDS in Botswana that allows us to compute the balance of costs and benefits associated with various policy mixes. Today Botswana is the only country in the world that is freely providing antiretroviral medication to all those who need it. We conclude that medication-only programs can not avoid a population decline and in some cases it decrease social welfare even relative to doing nothing at all. Prevention-only programs always yield the highest welfare levels. School based programs and mass media type education programs are complementary. Adding a medication program to a combination of the two reduces the efficiency of the prevention interventions. Uganda has significantly lowered its HIV/AIDS prevalence without the use of medication. Our findings suggest that a policy-mix more focused on Uganda-type education campaigns and less on medication would be better for Botswana. ∗Department of Business Studies, University of Vienna, Brünner Strasse 72, A-1210 Vienna, Austria; e-mail: [email protected] †Department of Operations Research, Vienna University of Technology, Argentinierstr. 8/119, A1040 Vienna, Austria; e-mail: [email protected] ‡Department of Economics, State University of New York at Stony Brook, Stony Brook, N.Y. 117944384, USA, e-mail: [email protected] §Department of Operations Research, Vienna University of Technology, Argentinierstr. 8/119, A1040 Vienna, Austria; e-mail: [email protected]