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War on AIDS will be long, more funds needed, conference told

by Richard Ingham*

A global conference on AIDS was to get down to business yesterday after hearing that victory against the disease lay beyond the farthest horizon and endangered lives could only be saved with inflows of money.
Funding, access to treatment, beefing up prevention against the human immunodeficiency virus (HIV) and an array of social evils from stigma to violence against women are the headline issues at the six-day parlay.
UN Secretary General Ban Ki-moon, in Sunday's opening ceremonies, urged wealthy donor countries to live up to UN and G8 commitments to achieve universal access to lifeline anti-HIV drugs by 2010.
"As the fight against AIDS nears the end of its third decade, we are still facing a huge shortfall in resources," Ban warned.
"The responses to HIV and AIDS require long-term and sustained financing. As more people go on treatment and live longer, budgets will have to increase considerably over the next few decades. In the most affected countries, donors will have to provide the majority of the funding."
More than 25 million people have died from AIDS since the disease first emerged in 1981, and 33 million people today are living with HIV.
Ninety percent of those infected live in poor countries. In the past two years, there has been a major boost in help for these people, but even now, only three million individuals, or less than a third of those in need, have access to precious antiretroviral drugs.
Margaret Chan, director general of the UN's World Health Organisation (WHO), warned that the war on AIDS would be protracted.
"We dare not let down our guard. This is an unforgiving epidemic," she warned. "We are going to be in this for the long haul."
"The end of AIDS is nowhere in sight," said Peter Piot, executive director of the UN agency UNAIDS. "Every day, almost three times as many people become newly infected with HIV as those who start taking antiretroviral therapy."
The 17th International AIDS Conference is the first to take place in Latin America, a region with entrenched stigma against people with HIV.
More than 22,000 scientists, policymakers and field workers are attending, making it the second largest conference in the history of the disease, and the largest in a developing country.
Dancers in flowing white-and-red robes, a mariachi band and giant Mexican puppets provided a colourful touch to opening ceremonies, while a 12-year-old Honduran girl with HIV, Keren Dunaway-Gonzalez, was loudly cheered for an address touching on the curse of AIDS stigma.
"Many of us want to be doctors or teachers. I want to be a singer. But these dreams will only be possible when we have medicines, when we're accepted in schools, and when we can grow up in an atmosphere free from violence, stigma and discrimination," she said.
VIPs attending the biennial conference include Scottish rock singer Annie Lennox and former US president Bill Clinton.
According to UN agency UNAIDS, around 10 billion dollars was spent last year fighting AIDS in poor countries, a massive rise compared with the start of the decade but still more than eight billion dollars short of what was needed.
The conference theme, "Universal Action NOW," reflects an appeal to political leaders to maintain their effort, amid worries about a money crunch as the cost of treatment spirals as more people go on drugs.
Questions have been raised in books and medical journals as to whether AIDS should still be considered exceptional if antiretrovirals have turned HIV from a death sentence to a manageable disease.
Some have even suggested the funds spent on this disease might better allocated to combating malaria and other, less-visible killers.
Piot, who steps down as UNAIDS chief at year's end, argued forcefully against this.
"We must categorically reject any attempt to so-called 'normalise' AIDS, or treat this epidemic as just one of many medical problems," he said. "Now, more than ever, do we need an exceptional response… there's not 'too much money going to AIDS' but too little.'"