The moral and fiscal implications of antiretroviral therapies for HIV in Africa

Journal article

Thanks to antiretroviral therapies (ART), people living with HIV (PLHIV) can now have a near-normal life at a cost of a few hundred dollars per year. We postulate that given this new low cost of maintaining lives, there is a moral duty to rescue those who are infected. This obligation creates a financial quasi-liability which for some African countries is comparable to their debt-to-GDP ratios. We construct a model to show that expenditure on prevention can pre-empt some of these liabilities. However, even with optimal prevention the quasi-liability is likely to remain too high to be affordable for a significant number of African countries. Extending the model to two players, we show that if the international community accepts part of the quasi-liability, as it does, it should finance a broadly equal share of prevention and treatment of future infections to mitigate moral hazard and avoid sub-optimal investment in prevention.

Authors: Collier, P; Sterck, O

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Oxford University Press
• Journal: Oxford Economic Papers
• Volume: 70
• Issue: 2
• Pages: 353–374
• Publication date: 2018-02-09
• Acceptance date: 2018-01-05
• DOI: 10.1093/oep/gpy001
• EISSN: 1464-3812
• ISSN: 0030-7653
• Language: English