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World War on AIDS -- at Last

WebMD Health News

June 25, 2001 -- At last the world is facing up to its 20-year-old AIDS crisis. Whether it is a case of "better late than never" or "too little too late" remains to be seen.

Beginning today, the United Nations will formally take up the issue of AIDS. After three days of deliberations -- which follow months of behind-the-scenes wrangling -- the General Assembly will vote on a "Declaration of Commitment on HIV/AIDS" that will dictate the world's response to the worldwide epidemic. It marks the first time world governments have met to plot a single, global response to a health threat.

"It is a bit late, but it is a historic moment," says Peter Piot, director of the Joint United Nations Program on HIV/AIDS (UNAIDS). "It marks the final stage of the transformation in understanding AIDS from a medical curiosity to a problem that touches the economic and social security of the entire world."

How big is the problem? Some 36 million people are living with HIV -- 5.3 million of them infected just last year -- and 21.8 million people already are dead. A UNAIDS map of the world shows that AIDS rates are rising fast in nearly all of Asia, Eastern Europe, the Caribbean, and sub-Saharan Africa. Growth is slow in the U.S., Australia, Brazil, Argentina, and Western Europe due to the impact of anti-HIV drugs. Only two nations, Thailand and Uganda, have shrinking AIDS prevalence -- and both face a resurgence of the epidemic without continued effort.

Solving the problem won't be easy -- or cheap. A UNAIDS analysis of the problem, published in the journal Science, says effective AIDS prevention and treatment will cost $3.2 billion next year and ramp up to $9.2 billion each year by 2005. And these are conservative estimates.

"Spending on the battle against AIDS in the developing world needs to rise to roughly five times its present level," says United Nations Secretary-General Kofi Annan, who opened the conference by calling for the creation of a "Global AIDS and Health Fund" to be operational by the end of this year.

This fund is a key point of contention among national delegations. The draft declaration calls for funding both HIV preventionandAIDS treatment -- including the new combination therapies now available only to those who can pay for them.

"The declaration of commitment, which we hope will be underwritten by the U.N., really puts it that prevention and care are intrinsically linked," Piot tells WebMD.

Not all nations agree that state-of-the-art treatment can be offered to everyone who needs it. The U.S. -- which named the CEO of a major pharmaceutical company to its official conference delegation -- has been reluctant to join the call for universal access to AIDS drugs.

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