By Lucy Clement
US Secretary of State for Health Tommy Thompson was booed off stage at this month's International AIDS Conference in Barcelona.
Activists furious at the USA's failure to deliver cash for the fight against HIV and AIDS stormed his press conference with placards reading "Where is the $10 billion?" and "Wanted: Bush and Thompson for murder and neglect of PWAs [people with AIDS]".
The United Nations agency UNAIDS estimates 68 million people will die because of AIDS in the 45 most affected countries between 2000 and 2020 - unless treatment and prevention efforts are massively expanded.
In the previous two decades 13 million have died in those countries. In some southern African countries - the epidemic is most prevalent in sub-Saharan Africa - up to one-half of all new mothers could die of AIDS. In Botswana almost two in five adults are now HIV-positive.
The epidemic is now spreading beyond southern Africa. The most rapid rises in infection rates have been in Russia and Eastern Europe. China saw a 70% rise in reported cases in the first six months of 2001. Indonesia and parts of western and central Africa which previously had steady rates of infection are also now seeing rising prevalence.
Big news at the International AIDS Conference was that a vaccine trial is to begin later this year in Thailand. In over 20 years since the virus was identified, the search for a vaccine has been a slow one. Only eight vaccines are currently being tested; most are in the early stages of development. The major drug companies, which produce the expensive antiretroviral treatments for AIDS, are accused of not
making the search for a vaccine their priority.
Protesters were once again targeting the drug companies at this year's AIDS Conference, holding lunchtime pickets of GlaxoSmithKline's conference stall. Despite years of campaigning, the pharmaceutical firms are still refusing to surrender their patents on antiretroviral drugs and to allow cheap generic versions to be
Less than 4% of those in need of antiretroviral treatment in the developing world have access to it, and UNAIDS says six million people in the developing world will die within two years without antiretroviral therapy. This, though, is not enough to convince the pharmaceutical firms to part with their profits. They continue to
bleat meek excuses that it is not their fault.
The Vice President (HIV Business for the United States) of Glaxo Smith Kline says public health infrastructure, not drug pricing is to blame for lack of access to treatment in poor countries.
Delegates also attacked economists whose cost-benefit analysis showed that antiretroviral therapy "isn't justified" and money would be better spent on prevention. They demanded that the conference move on from such arguments. "Access to adequate care and treatment is a right, not a privilege," said Peter Piot, the Executive Director of UNAIDS.
There is some cause for hope - 11 countries in Latin America and the Caribbean have policies and laws guaranteeing antiretroviral treatment - although the enforcement of such rules is not yet consistent. Uganda has succeeded in getting its infection rate down from 8.3% in 1999 to 5% in 2001 after a massive prevention campaign; Zambia is on the way to doing the same.
But the money to fight AIDS falls far short of what is needed.
Worldwide this year there is $3 billion in international funding - by 2005 low and middle-income countries anticipate $10 billion a year will be required. Is this an impossible sum? No. It is just two-thirds of the combined 2001 profits of drug firms GlaxoSmithKline and Merck & Co.
High-profile campaigns like that in South Africa, supported by solidarity action in the US, have forced the drug companies to make some concessions. Much more of the same will be needed, though, to stop the spread of HIV.
Making profits while people die
~GlaxoSmithKline's pre-tax profits in 2002 - $8.8 billion
~Merck & Co's net income in 2001 - $7.28 billion
~Based on 2001 Annual Results, GlaxoSmithKline had sales of GBP 20.5 billion ($29.5 billion) and profit before tax of GBP 6.2 billion ($8.8 billion)
UK infection rates up
In 2001 a record number of new HIV cases were diagnosed in the UK - 4,163. Since 1999 a majority of the UK's HIV infections have been contracted through heterosexual sex. Most of these involve people from African communities with connections to countries where prevalence is high.
The number of men infected through gay sex fell again last year after an increase in 2000. However, there are fears that too many young gay and bisexual men are complacent about the likelihood of infection. A recent US study showed that three-quarters of gay and bisexual men in US cities who had HIV did not know they were infected,
Facts about HIV
~In Botswana 39% of adults have HIV, up from less than 36% two years ago.
~Half of all new adult infections are among young people aged 15-24.
~Fourteen million children have lost one or both parents to AIDS.