Mead Over at the Center for Global Development looks at the downward revision of HIV prevalence figures by the UN. After dissecting the reasons for the flip, which he largely attributes to more accurate data from India, he goes on to add:
So the scandal here is not about exaggeration of the total number of HIV infections. It's about the failure of international donors over a period of 20 years to conduct enough research on HIV prevention. The world seems to be split between two types of people. On the one hand are those who think the benefits and cost-effectiveness of HIV interventions are so obvious that it would be unethical to divert money from implementation to research. In this well populated category we can place the $250+ million Gates-funded Avahan prevention program in India, which favored rapid start-up of implementation over building in data collection that would have permitted a rigorous evaluation so that those in India and elsewhere could learn how well it was working. On the other hand are people who think HIV prevention is hopeless because "people can’t change their sexual behavior" and who are only willing to consider medical interventions like treatment or a vaccine while opposing HIV prevention research. Where are the donors in the middle, who believe that HIV prevention may be cost-effective, but recognize the gaps in knowledge and are willing to invest to find out exactly how cost-effective they can make it?
You can read more about the need to support HIV prevention research, and act on your beliefs, by going to The Sydney Declaration: Good Research Drives Good Policy and Programming - A Call to Scale Up Research issued by the International AIDS Society in July 2007:
Ten per cent of all resources dedicated to HIV programming should be used for research towards optimizing interventions utilized and health outcomes achieved.
Yet, as I have noted here before, simply conducting more research programs that focus on changing the behavior of individuals and are not designed from the beginning to achieve scale, are not our answer either.