Increased scrutiny over the resolve of governments to follow through with the political and financial commitment to curb the escalating global impact of HIV/AIDS is likely to be a major outcome of the XIV International Conference on AIDS.

The conference, which draws to a close in Barcelona this week, has presented a grim picture on the global progress of HIV/AIDS, with new United Nations figures debunking hopes that the epidemic had plateau’d and growing fears of a pending explosion in new infections in Asia-Pacific and Eastern Europe.

Delegates have issued a major challenge to governments in developed nations to invest the resources needed to build on encouraging developments in fighting the epidemic that have surfaced since the last International AIDS Conference in Durban.

From the opening ceremony keynote speech by Spanish politician Jos?aria Mendi-luce that accused civil agencies and political establishments of complacency, it was clear that international governments would be put on trial.

We are tired of the egoism of too many rulers that pretend to be leaders, Mendiluce announced to a crowd of 16,000 people who gathered for the ceremony. Politics has to respond to challenge -¦ Now we find ourselves at the crossroads. We must decide with responsibility and commitment which path we wish to take and what are our priorities.

In particular, trailblazing policy leadership by the Brazilian government in declaring a national health emergency over mounting new HIV infections in the nation -“ leading to patents for HIV drugs being dismantled and widespread distribution of treatments to the population -“ is seen as a model for other international governments.

A lot of unexpected progress has taken place since Durban. We’ve got an established global fund, we have governments from around the world saying they’re committed to action and the pharmaceutical markets have been broken wide open from what Brazil has done, Don Baxter, CEO of the Australian Federation of AIDS Organi-sations (AFAO) told Sydney Star Observer this week. Baxter was attending the conference in Barcelona.

Part of what Brazil has done in the two years since the Durban conference is help break down all the assumptions which have been made on how drugs could be distributed to people with HIV.

The feeling now is that the growing epidemic could be fixed, if we can get these governments moving.

Also high on the agenda of delegates has been the need for richer countries to invest further funds in the fight against HIV.

For about five to six billion dollars, we could have a major impact in terms of the number of deaths globally. We’re talking about saving five to six million people within the next two years, Baxter said.

What the conference has made very clear is that we could actually do this now, except for the obstacles of political will and dollars -“ and it’s not a large amount of dollars. We could save millions of lives and that has led to a growing feeling of anger toward the governments of rich nations.

International reaction to new breakthroughs in scientific technology, including the promise of a new prevention vaccine within five years and a new type of drug to treat HIV infection, has been mixed.

Already, HIV experts have urged caution over claims that a Californian-developed prevention vaccine, which is said to work by stopping the HIV virus from entering cells, could be on the market within the promised time frame of five years.

The scientific feeling is that five years is optimistic for getting a vaccine to that stage and then rolled out to a population. Another thing we should expect is that our first vaccines are not going to be shit-hot ones, Baxter said.

A new class of HIV drug called T-20 (enfuvirtide) was touted as a possible solution to the concerning discovery that some strains of the HIV virus had become resistant to traditional drug cocktails.

Results of two clinical trials on T-20 showed that the drug reduced viral loads to undetectable levels in twice as many patients as conventional drug treatments.

However, despite these promising results, scientists maintain that T-20 could never completely eradicate the virus from the body after it was discovered that every immune system T-cell infected by HIV is implanted by a molecular memory of the virus.

The latent reservoir for HIV in resting memory CD4 T-cells guarantees lifetime persistence of the virus -¦ Professor Robert Siliciano, professor of medicine at John Hopkins University told The Times this week.

I realise that this conclusion is hard to hear, but I think that it is a disservice to persons living with HIV to ignore what the science is telling us.

Despite these worrying discoveries, Baxter said that people should maintain hope in new drug technology.

I don’t know if the general feeling is that the technology is falling short of the epidemic, but we certainly would have hoped they had moved quicker with coming up with new technology to fight the disease. They’re moving -“ it’s better than nothing.

So I think the outcome from this conference will be to move beyond just trying to combine science and action to combining science and action with anger. We now need to see real developments, both scientifically and politically.

The XIV International Conference draws to a close in Barcelona tomorrow. Full details of the conference and further reports can be obtained at the official website www.aids2002.com.

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