Brown Regina, Evans Nicholas Greig
Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA.
Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Med Ethics. 2017 Feb;43(2):118-123. doi: 10.1136/medethics-2015-103125. Epub 2016 Jul 8.
A sterilising or functional cure for HIV is a serious scientific challenge but presents a viable pathway to the eradication of HIV. Such an event would be extremely valuable in terms of relieving the burden of a terrible disease; however, a coordinated commitment to implement healthcare interventions, particularly in regions that bear the brunt of the HIV epidemic, is lacking. In this paper, we examine two strategies for evaluating candidate HIV cures, based on our beliefs about the likelihood of global implementation. We reject possibilist interpretations of social value that do not account for the likelihood that a plan to cure HIV will be followed through. We argue, instead, for an actualist ranking of options for action, which accounts for the likelihood that a cure will be low cost, scalable and easy to administer worldwide.
实现对艾滋病毒的消毒或功能性治愈是一项严峻的科学挑战，但却是根除艾滋病毒的可行途径。就减轻一种可怕疾病的负担而言，这样的成果将具有极高的价值；然而，目前缺乏协调一致的努力来实施医疗保健干预措施，尤其是在受艾滋病毒疫情影响最严重的地区。在本文中，基于我们对全球实施可能性的看法，我们研究了两种评估候选艾滋病毒治愈方法的策略。我们摒弃了那种不考虑治愈艾滋病毒计划能否真正实施可能性的社会价值可能性解释。相反，我们主张对行动方案进行现实主义的排序，这种排序要考虑到治愈方法在全球范围内成本低廉、可扩展且易于实施的可能性。
