Bangkok Post - July 21, 2004
Apiradee Treerutkuarkul

Last week saw 17,000 people gather in Bangkok to put their heads together to solve the global HIV/Aids crisis. The message heard over and again throughout the six-day conference _ from United Nations Secretary-General Kofi Annan, to former South African president Nelson Mandela to celebrities like Richard Gere _ was the need for serious leadership and more money if HIV/Aids is ever to become a blight of the past.

But by the time the curtain came down on the meeting on Friday evening, there remained no clear sign of a unified commitment between leaders or an increase in funds to help turn the tide on the pandemic, which is on the rise across every region of the world.

The UN secretary-general showed disappointment in the effort. ``Where's the global solidarity to tackle HIV/Aids?'' he asked before comparing the sum committed to fight international terrorism, which threatens thousands of lives, to that set aside to combat HIV/Aids, which has already killed millions.

The key message on the need to build closer working relationships between governments, private enterprise and grassroots communities to confront the deadly virus was in fact a reiteration of statements made two years ago at the 14th International Aids Conference in Barcelona.

Joep Lange, president of the International Aids Society, a co-organiser of the event along with the Thai government, claimed much progress had been made despite the absence of a declaration of a unified programme between national, scientific and community leaders to give direction in tackling HIV/Aids problems.

``Never before has the role of leaders been so widely discussed as at the Bangkok conference,'' he said. ``The convention in the past brought together just scientists and community leaders to talk about Aids and its prevention. This year was the first time national leaders have become involved. It matters and could prove that solutions to HIV/Aids are on the right track.''

A political push is needed not only in countries with the highest incidence of HIV/Aids but also in the United States and the European Union states as major donor countries. The US came under fire over its drug-funding policy, which is based mainly on bilateral deals, and for preferring abstinence over the use of condoms as a means to prevent the spread of the virus.

Randall Tobias, head of the US Aids Coordinator, argued that his country's contribution to fighting Aids more than equalled that of the rest of the world combined and so he ruled out any increase in donations to the Global Fund to fight Aids, Tuberculosis and Malaria.

The biggest achievement of the conference may have been the wake-up call to the need to prevent the further transmission of the virus in Asia and to treat those living with Aids in the world's most densely populated region. This was the first time these issues had taken centre stage, according to Mr Lange.

The need for access to drugs, as at all past conferences, was a central plank of the meeting, hence the theme: Access for All. The price of anti-retroviral drugs used to treat HIV/Aids has fallen significantly in recent years, but they still remain beyond the reach of millions, mostly in poor developing countries. The row over patent and intellectual property rights continued to rage and the pharmaceutical giants were again portrayed as the bogeymen.

The least successful element of the conference was the scientific track, since no new vaccine or drug breakthrough was provided. With little new data presented, attention fell on long-term prevention approaches and investments in basic infrastructure which could make a real difference in the fight against Aids over time.

Women and children are increasingly falling victim to the virus and condoms are not always an option the women's partners are prepared to consider. A call for a serious look at microbicides as an avenue for protecting people from the virus received a strong voice.

Prime Minister Thaksin Shinawatra, as leader of co-host Thailand, promised more low-cost anti-retroviral medicines to people living with Aids and urged the leaders of other countries to do likewise.

But his promise to launch a harm-reduction, or preventive, programme could come back to haunt him. His government has yet to figure out how to translate his words into action and it became a target of activists during the conference who condemned the government's violent war on drugs waged last year for driving users underground and making HIV more difficult to control.

Sombat Thanprasertsuk, director of the Disease Control Department's Bureau of Aids, Tuberculosis and Sexually Transmitted Infections, said the government understood the problem and was more open to allowing people living with Aids and the Thai Drug Users' Network a voice at the conference.

However, he was not sure if the public would accept the call for the distribution of clean needles and methadone as most people still consider the taking of drugs illegitimate. Pushing the idea at the wrong time would only produce a negative response, he said.

On the other hand, Dr Sombat said people living with Aids and the Thai Drug Users' Network should be happy with the progress that has been made and the continuing activities and campaigns to develop public acceptance of the issues one step at a time.

Perhaps the most important task for the government after this conference is to review its education policy and provide a stronger approach for children to learn about Aids. ``The country's record on reversing the spread of this epidemic can no longer guarantee fruitful progress in combating the virus as long as a stronger education programme and the prevention of Aids among the public is lacking,'' Dr Sombat said.

Nimit Tien-Udom, director of the non-governmental Aids Access Foundation, said a committee should be formed to bring together government, medical researchers and community workers to speed up efforts to tackle complicated HIV/Aids-related problems.

Without significant progress in backing the commitments given at the conference, Mr Nimit said, many millions more may become infected with HIV/Aids before the next International Aids Conference convenes in Toronto in two years' time to rehash the same old issues.
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