Is the end of AIDS in sight?
the deadliest sexually transmitted sickness of all time. The struggle involves not only dazzling science but also old-fashioned insights into human behaviour, rational and irrational. Many people who do not have HIV, the virus that causes AIDS, know they are at risk.
They can take pre-exposure prophylaxis (PrEP), a kind of drug that reduces their chance of contracting it by 99% or so. This comes as a daily pill, and is popular among gay men in rich countries. However, there is a much larger group of people at high risk, for whom a daily pill is far from ideal: heterosexual women in poor places where HIV is still very common.
If their boyfriends discover they are taking the pill, they may conclude that their girlfriend does not trust them, or that she is planning to cheat on them. And a depressing number of boyfriends who suspect such things react violently. A high-tech solution is on the horizon: cabotegravir, from ViiV Healthcare, a single injection that lasts for two months and is much more discreet than a daily pill.
Alas, it is new, costly and not yet widely available, especially in Africa, where the virus is most widespread. So Patrick Mdletshe of the KwaZulu Natal Provincial Council on AIDS in South Africa offers a low-tech fix: stuff cotton wool in the bottle so the daily pills don’t rattle and your boyfriend won’t notice that you are taking them. UNAIDS, a UN body, hopes to end AIDS as a major public-health threat by 2030, building on the staggering success of the past two decades.
AIDS, which weakens the immune system, has killed about 40m people—more than covid-19. However, the pace at which people are dying of it has fallen dramatically. In the early 2000s it was 2m a year, largely in poor countries, where
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