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The Ethics of Material Incentives for HIV Prevention

Monday, February 14, 2011 - 9:00am to 11:00am

Featured Panelists
Julia Kim
Cluster Leader, United Nations Development Programme
Peter Lamptey
President, FHI 360
Mead Over
Senior Fellow, Center for Global Development
Daniel Wikler
Professor of Population Ethics, Harvard School of Public Health

Moderated by
Amie Batson
Deputy Assistant Administrator for Global Health, USAID

As past efforts to prevent new HIV infections have not been entirely successful, HIV prevention implementers are looking to innovative solutions. One challenge long-cited as an epidemic driver without an apparent solution, has been the lack of economic power and agency, particularly for women. Qualitative research has suggested that women in high burden HIV countries have limited ability to access goods they need (e.g. basic food stuffs, education) and want (e.g. mobile phone, cars). Material incentives – whether supply-driven incentives for the service providers to increase service coverage and quality, or demand-driven incentives such as for example cash, school fees assistance or consumer goods to increase service uptake and thereby increase the effectiveness of the service at a population level – could be part of the solution. However, for a number of reasons (including operational, technical and ethical), these types of programs have had a long and controversial history in public health, education, and economic disciplines. In the past five years, a number of studies have examined the possibility of using such incentives to prevent HIV infection, with mixed results. Should such programs be implemented on a wide scale? What does our experience with family planning and incentives tell us? Is providing material incentives, for example, to achieve sexual behavior change or get more men circumcised, to avoid more new HIV infections ethical? Is it sustainable or does it even need to be? This debate will explore the ethical considerations of this innovative type of HIV prevention and public health solution.

Related Experts

Photo of Amie Batson
Non-Resident Fellow

Monday, February 14, 2011