Stopping the spread of HIV is within our reach. We can drastically curtail new infections by providing free needles for drug users and medication to prevent HIV.

In the below video, Elizabeth Pisani argues health policies that are supposed to be rational often fail due to the irrational nature of how HIV spreads, through sex and drug use.

Addicts share needles because being caught with a needle could land them in jail today while getting HIV could kill them in a decade. Providing clean needles and taking away the fear of arrest solves the problem for drug users and the public health system. Such policies led to HIV prevalence between 1 and 4 percent in the U.K., Australia and the Netherlands compared to around 50 percent in New York, Jakarta and Moscow.

HIV transmission has dropped almost everywhere among sex workers due to condom use between 80 and 100 percent thanks to aligned incentives of the workers and their clients. This doesn’t apply in intimate relationships because of trust and romance.

HIV treatment has allowed people to live longer but also potentially spread HIV when they otherwise would have been dead, and thus not spreading HIV. We therefore need more prevention as we get more treatment.

It doesn’t make sense we would rather not help drug users, sex workers and gay men prevent HIV but then pay for lifelong treatment once they get HIV.