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Researchers, activists and major funders have agreed to a shift in the fight against AIDS to focus on prevention and especially helping women protect themselves.
With big pharmaceutical companies making their HIV drugs available cheaply to developing nations and with generic drugs available, speakers at the 16th International Conference on AIDS agreed the focus should move to preventing new infections.
"Prevention of HIV had slipped off the agenda and now is being pushed by unexpected quarters," Dr. Peter Piot, head of the United Nations AIDS agency UNAIDS, said in an interview.
That includes activists who had previously focused on getting lifesaving drugs to infected people, he said.
Opening the conference in Toronto on Sunday, Microsoft founder Bill Gates, who has donated hundreds of millions of dollars to AIDS programs, said he would be seeking good prevention programs that focused on women.
These will include the development of microbicides -- gels or creams that can prevent sexual transmission of the fatal and incurable virus.
Just over half, or 17.3 million, of the 34 million adults infected with the AIDS virus are women, according to the World Health Organization.
With more than 4 million new infections a year and 2.8 million deaths, the need for prevention is clear. But some political and religious leaders are standing in the way of effective programs, several experts said.
"The problem with prevention for many is that you cannot avoid dealing with sex and drugs," Piot said.
Barbara Lee, a California Democrat in the U.S. House of Representatives, said the administration of President George W. Bush may have to be forced into changing its policies that stress abstinence as the best prevention method.
GOING WITH WHAT WORKS
"What we see is a very ideologically driven administration, both domestically and internationally, trying to put their moral values ... on communities and countries," Lee told a news conference.
She is sponsoring legislation that would eliminate U.S. requirements that 33 percent of all funds spent on prevention go to promoting abstinence-only-until-marriage approaches.
"We know that abstinence only before marriage doesn't work," said Stephen Lewis, the U.N. ambassador to Africa for
AIDS.
The White House defended its policies. "Very little of what PEPFAR is doing in prevention in any focus country is in abstinence only," said Warren Buckingham country coordinator for the (U.S.) President's Emergency Plan for AIDS Relief in Kenya. "We all long for the day when there is an effective microbicide, but we are not there yet."
Until then counseling programs to help women speak up for themselves and to encourage men to respect women more might be more useful, Buckingham said.
Medecins sans Frontieres said the high price of newer medicines is driving up the cost of treatment for AIDS. As patients use first-line drugs, the virus in their bodies evolves resistance and they must move to new regimens, the group said in a report issued at the conference.
"In Nigeria 8 percent of patients on treatment for 18 months need second-line, which costs over seven times more than first line ($200 versus $1,473 a year)," said the group, also known as Doctors Without Borders.
(Additional reporting by Natalie Armstrong and Cameron French)
Comment by Julie Davids
