Global Policy Forum

By Stephen Leahy

Action - not promises or pledges or more meetings - is what will bring the HIV/AIDS pandemic under control and save tens of millions of lives, concluded delegates at the wrap-up of the 16th annual International AIDS Conference in Toronto Friday.

But when it comes to taking action, governments in the North and South are not doing nearly enough. The South African, U.S. and Canadian governments were singled out by some officials and activists for what amounts to willful negligence.

The government of South Africa remains "obtuse, dilatory and negligent about rolling out treatment" for HIV, preferring instead to promote lemon juice and garlic "cures", said Stephen Lewis, the U.N. special envoy for AIDS in Africa.For a number of years, South African President Thabo Mbeki had publicly denied any link between HIV and AIDS, and then resisted the use of antiretroviral drugs. Mbeki's health minister, Manto Tshabalala-Msimang, came to the Toronto conference to promote the use of lemons, garlic and beet root as treatments for AIDS.

Every day, between 600 and 800 people die of AIDS in South Africa, said Lewis, whose term as envoy ends this year. "South Africa's actions are wrong, immoral and indefensible," he said to thunderous applause during the five-day conference's final session. Later, conference co-chair Mark Wainberg, director of the McGill AIDS Centre in Montreal, asked how other countries could continue to let South Africa fail to provide adequate health care for its people. "We have sat back far too long watching South Africa deteriorate in terms of millions of people contracting HIV while their health minister prefers to talk about lemon juice," Wainberg told IPS.

Lewis also criticised the George W. Bush administration's insistence on abstinence as the main form of prevention, saying there is clear evidence that such programmes do not work unless they are part of other prevention methods like condoms. Moreover, dictating to other governments how they should allocate prevention money was "neo-colonialism", he said.

The U.S. government was also admonished for refusing to fund HIV/AIDS programmes that fail to pledge opposition to commercial sex work. And while funding by governments and other donor groups has improved significantly in recent years, there are troubling signs that political will has begin to ebb. "We are on the cusp of a huge financial crisis," said Lewis. A multi-billion-dollar funding shortfall is looming as the pledge by the Group of Eight (G8) most industrialised countries last year to achieve near universal access to treatment by 2010 is not being fulfilled, he said.

Global AIDS programmes will need 15 billion dollars this year and 22 billion by 2008, but the U.S. contribution will likely not exceed its present level of three billion dollars per year, he said. "That seems pretty paltry from the world's superpower," Lewis commented. The hope of universal access to treatment will be doomed without billions more in funding, he said, urging conference delegates and activists to pressure governments, especially the G8, to deliver on their promises. "This issue of resources makes or breaks the response to the pandemic," he said.

Political leaders' failure to fully invest in the fight against HIV/AIDS is tantamount to genocide, said Juilo Montaner, the president-elect of the International AIDS Society. The International AIDS Society organised the conference and is the world's leading independent association of HIV/AIDS professionals. Montaner is a respected AIDS researcher at the British Columbia Centre for Excellence in HIV/AIDS in Vancouver.

Current drugs are effective in greatly prolonging lives and should be made available to everyone in the world who is infected and would benefit, regardless of the cost, Montaner told delegates. Providing universal access to drugs would cost an estimated seven billion dollars annually, and about the same again for related testing and health care.

Despite a record 31,000 participants, the Toronto conference will be judged a failure without dramatic and rapid expansion of access to antiretroviral drugs for millions of people around the world and a simultaneous scale-up of prevention efforts, said Wainberg. "It makes absolutely perfect sense to give drugs to people so they will be less infectious and halt the spread of the disease," he said.

Wainberg, Lewis and other Canadian experts have chided the Canadian prime minister for not attending the conference and the lack of any new funding or programme announcements. In fact, the Canadian government presence at the conference has been invisible. "I'm appalled as a Canadian by Prime Minister Harper's absence," said Robert Fox, executive director of Oxfam Canada. That absence perfectly reflects the complete lack of political leadership on HIV/AIDS in Canada and in most of the developed countries, Fox told IPS.

Governments in the North don't take the issue seriously because the bulk of those infected are in the South, he said. There are programmes and drugs available to halt and even reverse the epidemic but the resources are lacking and governments in the North and South have not stepped up to the plate, he said. "We have to keep the pressure on governments so that in 2008 (the next conference) it won't be former presidents that are rocking the place, it should be current presidents."

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