Leaders in AIDS fight warn against complacency

Leaders in the fight against AIDS pleaded on Sunday for the world to keep up its momentum against the disease and step up funding for HIV treatment and prevention.

"It's the first time in the history of this epidemic that on a large scale we have results," Peter Piot, executive director of the UN agency UNAIDS, told a press conference at the opening of a six-day conference.

"We are entering into a new phase, with new challenges, challenges of sustainability," Piot said, pointing to the three million people in developing countries who are now on antiretroviral therapy.

Keeping them alive and expanding access to the drug lifeline "will require a sustained effort over several decades," he warned. "Dealing with AIDS now will require a long-term response."

The 17th International AIDS Conference, opening in the Mexican capital, is the first to take place in Latin America, a region with entrenched stigma against people with the human immunodeficiency virus (HIV).

Close to 22,000 scientists, policymakers and field workers were expected to attend, making it the second largest conference in the 27-year history of the disease, and the biggest in a developing country.

The gathering, held every two years, coincides with a relative lull in the long fight against the disease, marked by belated progress to bring antiretrovirals to badly-hit poor nations.

The theme, "Universal Action NOW," reflects an appeal to political leaders to maintain this effort, which is shadowed by worries about another money crunch as the cost of treatment spirals.

Questions have been raised in books and commentaries in medical journals as to whether the billions spent on AIDS could be better allocated to combating malaria and other diseases that are less visible but also lethal.

Pedro Cahn, president of the International AIDS Society (IAS) which organizes the conference, argued that spending on HIV had a spinoff on general health care, as well as help for women and people with other sexually transmitted disease.

"We are very worried about the wrong idea that we should stop fueling funds for HIV/AIDS," said Cahn.

Insiders said they did not expect any breakthrough announcement in the arena of drugs, and braced for confirmation that the quest for a vaccine and an HIV-thwarting vaginal gel was mired in setbacks.

More positively, though, evidence has emerged that male circumcision can help prevent HIV infection among men -- a finding of great significance in southern Africa, the epicenter of the pandemic.

In new report published on the eve of the conference, American health watchdogs acknowledged they had substantially underestimated the number of new HIV infections in the United States.

About 56,300 people were infected with the virus that causes AIDS in 2006, a figure 40 percent higher than the previous estimate of 40,000 new infections a year, the US Centers for Disease Control and Prevention (CDC) said.

Gays, bisexuals and African-Americans account for most of the increase, it said.

Reacting to the CDC figures, US presidential hopeful Barack Obama vowed to put "new focus" on America's combat against HIV, with a national strategy to boost prevention efforts, testing and access to treatment.

"Combating HIV/AIDS also demands closing the gaps in opportunity that exist in our society so that we can strengthen our public health," Obama said.

"We must also overcome the stigma that surrounds HIV/AIDS -- a stigma that is too often tied to homophobia."

His Republican rival John McCain pledged to fight HIV/AIDS by "reducing drug costs through greater market competition" and "work closely with non-profit, government, and private sector stakeholders to continue the fight."

Some 10 billion dollars was spent last year fighting AIDS in poor countries, but this was 8.1 billion dollars short of what was needed, according to UNAIDS.

Less than a third of infected people in developing countries have access to antiretrovirals, which became available in rich countries 12 years ago.

Simply to maintain the current pace of drug access will require funding to rise by 50 percent by 2010. Even more will be needed to meet the goal of universal access, set for that year, by the UN General Assembly.

More than 25 million people have died from AIDS since the immune-wrecking disease emerged in 1981 and around 33 million today have HIV.