Wheeling out HIV elimination

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Science  11 Dec 2020:
Vol. 370, Issue 6522, pp. 1287-1288
DOI: 10.1126/science.370.6522.1287-f

Several sub-Saharan countries have been prioritized by the Joint United Nations Programme on HIV/AIDS (UNAIDS) for HIV elimination. This will require 90% treatment coverage by the end of 2030, but poor transport infrastructure means incomplete access to medication in some countries. Palk et al. developed a geospatial model for understanding the difficulties of reaching health care facilities in Malawi, a country severely affected by HIV. They mapped health care facilities with the density of HIV prevalence and quantified the difficulty of travel across Malawi's landscape by a friction surface raster map. If bicycles are used, then the catchment size for a health care facility is substantially larger than if people walk, and the required 90% treatment coverage for elimination becomes achievable. Bicycles are already used as “ambulances” in rural areas, but Malawi's bicycle fleet is small and in poor repair. One straightforward route for beating HIV (and many other health conditions) here and in similar countries could lie simply in boosting the supply of bicycles, an established and well-tested technology.

Lancet Glob. Health 8, E1555 (2020).

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