NAIROBI, Sept 26 (AFP) - The United Nations' top official on AIDS told Africa on Friday that its long battle against AIDS was at a turning point, but the key to a further influx of donor funds lay mainly with African countries themselves.
In a speech to close a six-day forum on Africa's AIDS crisis, UNAIDS Executive Director Peter Piot said he believed the conference "will be known in history as the time when we began to break the back of the epidemic and we became serious about access to treatment."
But he bluntly warned that for donor countries to put their hands deeper into their pockets, they would have to be convinced that their cash was not being siphoned off or wasted.
And, he said, African countries had to ensure fairness in the way that long-awaited anti-HIV drugs were administered.
It was vital to avoid "a Darwinian process of the survival of the fortunate" in which the military, or men with power and money, were favoured over women, children and the poor, he warned.
Piot said that this week had witnessed "a breakthrough" in the fight to stem the tide of AIDS in Africa, the home for nearly 30 million of the more than 40 million people around the world who have HIV or the full-blown disease.
Meetings in Nairobi and at the United Nations in New York showed "we have undeniably made great strides on financing the response... we are no longer working in an environment without major resources," he said.
In two years, spending on AIDS in Africa had nearly doubled, to 950 million dollars in 2002, and today precious antiretroviral drugs were at last becoming available at a low cost, he said.
Much more money was needed, he said.
This would have to come from African countries themselves, especially those with access to "billions of oil money" and with large military budgets, as well as from wealthy Western countries, he said.
But, in a clear reference to the corruption and waste endemic to much of Africa, Piot said donors would only understand "the immorality of underfunding... when we can show that the available money is well spent, and programmes reach those that need it.
"Monitoring and evaluating what we are doing become more crucial than ever," he said.
Ceremonies to close the six-day International Conferences on AIDS and Sexually Transmitted Infections in African (ICASA) were briefly disturbed by demonstrators demanding enhanced access to drugs.
ICASA's main focus was how to scale up distribution of the antiretrovirals, the powerful "cocktail" of medications that, for millions in the rich world, has turned HIV into a manageable but not curable disease.
Only 75,000 Africans have access to antiretrovirals, according to figures released this week.
The goal is to raise this to more than two million by the end of 2005, but to achieve that will require an effort without precedence in medical history, experts said.
It will require big investment in training doctors, nurses and support staff; building distribution and storage networks for the drugs; and setting up clinics and laboratories in remote areas where patients can be treated.
ICASA is held every two years, alternating with the International AIDS Conference. This year's gathering was attended by nearly 8,000 people, ranging from doctors and researchers to government officials and non-governmental organisations (NGOs).
The 14th conference will be held in 2005 in Abuja, Nigeria.
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