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Retrovirals work. They let people lead normal lives, and make HIV no longer a death sentence. We now have semi-experimental vaccines that stave off the disease, and I strongly expect a full cure being on the market within a decade at most.
Even if PEPFAR wanted to run indefinitely, it will face the guinea worm 'problem' of not having a disease to tackle, and unless you're 70 years old, it'll happen in your lifetime.
I'll generally defend PEPFAR on its own merits, but the blackpill for PEPFAR-as-promoted is less about the effectiveness of the drugs themselves, and what the actual provisioning of even very effective drugs actually looks like, on the ground. This discussion is specific to PrEP (and this context that got me to write it up), but as far as I can tell it's pretty endemic to the program in the areas it's most critical.
That might change literally overnight if a full cure, extremely long-lasting PrEP, or sufficiently easy and effective vaccine comes about and is accepted, but I'm not highly confident for even that.
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So its just like a normal charity. It keeps people alive who cant keep themselves alive. Its a charity you anticipate will no longer exist in 70 years due to scientific advances wholly unrelated to the charity and the people who benefit from it, other than the fact they will also incidentally benefit from those advances.
70 years? 20 at the worst. I would take bets at worse than even odds at a mere ten.
I really don't understand this line of thinking. It's akin to condemning advocating lifestyle 'solutions' for diabetes right before they discovered porcine insulin. After people have been publishing papers saying, hey, this funny little trick seems to work.
That is still wholly unrelated to PEPFAR. You aren't alleging that PEPFAR recipients are at the bleeding edge of HIV-cure research are you?
How is that unrelated? In the absence of PEPFAR, I have good reason to believe we will cure HIV in mere decades. What PEPFAR does is ensure that those who are suffering from it right now live long enough to receive said cure.
Even if the cure doesn't materialize, people are still alive, and longer than they would have been in its absence.
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