AS DELEGATES met at the 15th International AIDS Conference in Bangkok, the prospects for bringing HIV under control looked bleak. The numbers of people infected or likely to become so in the near future are horrendous, as are the sums of money that will be needed to treat them. Most worrying is the lack of global leadership. Many wealthy nations are failing to keep their promises on funding, and this can only lead to deeper trouble.
Some 38 million people are infected with HIV, of whom 4.8 million caught the virus last year. About two-thirds of all HIV-positive people live in sub-Saharan Africa, where their chances of receiving costly anti-retroviral drugs are slim. But it is the situation in Asia that is now exercising the minds of epidemiologists. Till now, the Asian epidemic has grown mostly in marginal groups such as prostitutes and injecting drug uses. But epidemiologists warned in Bangkok that the number of infections is about to reach a tipping point, after which it will spread rapidly through the general population, as it has in Africa.
Money to tackle this and other crises is in short supply. After opening the conference, the UN secretary-general Kofi Annan criticised governments in the US and Europe for not supporting the Global Fund to fight AIDS, Tuberculosis and Malaria, which was set up to mount aggressive campaigns against all three diseases. The fund needs $3.5 billion to support its programme in 2005, but it looks as if Europe is dragging its heels over its expected $1 billion contribution, and the US intends to halve the $1.2 billion it was expected to chip in. Instead, the US government is directing money to poor countries though its own channels.
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There are always, of course, more places to spend money, but one request deserves particular attention. Speaking in Bangkok, Seth Berkeley, president of the non-profit International AIDS Vaccine Initiative, called for a doubling of the money spent on vaccine research to $1.2 billion a year. Dozens of candidate vaccines are now waiting in the wings, but developing and testing them is where most of the cost lies. That money is less likely to come from pharmaceutical companies simply because vaccines do not generate as much profit as drugs.
It is true that creating a vaccine is no trivial task. HIV has outmanoeuvred every vaccine created in the past two decades. But a vaccine is still our best hope for halting HIV鈥檚 spread to ever more people. The G8 group of wealthy nations recently backed the Global HIV Vaccine Enterprise to coordinate a plan for vaccine development. It was a much-needed fillip, but without more money we will have to wait too long for that plan to deliver.
