The reason everyone else is more cost effective is that in the US we spend alot of money on grim cases where as others say hasta your goose is probably cooked so why even try.
BTW, I said my friend lives in Thailand but he travels all around the world. He has worked in over 40 countries in the Americas, Africa, Asia, the Carribean and Eastern Europe. He’s one of the foremost experts on HIV/AIDS in the world.