JAMA
January 12, 2011, Vol 305, No. 2, pp 123-212
http://jama.ama-assn.org/current.dtl

Commentaries
Ethical Allocation of Preexposure HIV Prophylaxis
Lawrence O. Gostin, Susan C. Kim
JAMA. 2011;305(2):191-192.doi:10.1001/jama.2010.1975

[First 150 words per JASMA convention]

Civil society–led movements transformed global AIDS action from deep skepticism about extending antiretroviral (ARV) treatment in low- and middle-income countries to a historic scaling up of treatment toward universal access. During its first phase (2003-2008), the US President’s Emergency Plan for AIDS Relief (PEPFAR)—the largest national commitment to combat a single disease—supported treatment for more than 2 million people, care for more than 10 million people, and prevention of mother-to-child transmission in 16 million pregnancies. 1 The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), a unique international financing institution, has committed $19.3 billion in 144 countries to support large-scale prevention, treatment, and care, with most resources devoted to AIDS treatment. 2

The AIDS movement, however, is at an inflection point due to the interplay of key health and economic determinants—the global financial downturn, tight foreign aid budgets, and intense resource competition. Even with historic global engagement, human …