The New York Times - August 14, 2006
Lawrence K. Altman

Mr. Clinton, speaking here at the first full day of the 16th International Conference on AIDS, said that "the leaders don't necessarily have to be the reigning head of government if you have a critical mass" and "the government does not undermine you with counterproductive policies."

He spoke before 6,000 people who jammed a hall where he and the computer entrepreneur Bill Gates answered questions for more than an hour from a moderator, Charlayne Hunter-Gault, and the audience. Hundreds more among the 24,000 conference participants sat in overflow rooms or could not get into the hall. They had all skipped scientific presentations to listen to what was dubbed the Double Bill, a session that dominated the day's events.

Mr. Clinton and Mr. Gates, who each have charitable foundations that support the fight against AIDS, have become the newest popular faces of the campaign as they have traveled the globe, often together, to learn more.

Both men praised the Bush administration's program, Pepfar, the President's Emergency Plan for AIDS Relief, a five-year, $15 billion program that serves 16 countries, 13 of them in Africa. One part of the program aims to help provide pregnant women with the pills to have healthy babies.

Mr. Clinton said, "Pepfar, on balance, has done a terrific amount of good."

Mr. Gates said, "On the treatment front, Pepfar is a great success, and we need to get that story out."

"It's incredible in its impact," Mr. Gates said. "Lives are being saved, and this thing is being run very well."

Mr. Clinton disagreed with a participant from Ecuador who criticized him for doing very little against AIDS when he was president, saying, "I did a good job" but met opposition from Congress. "I did make a lot of mistakes when I was president, but that was not one of them," he said, drawing laughter.

The conference's theme, "Time to Deliver," is intended to galvanize the world to apply the prevention and treatment methods that are known to work and to develop the new tools needed to eventually stop AIDS.

Moreover, the organizers say, so many lives - and so much money - are now at stake that everyone involved in fighting the pandemic must be held accountable.

"This is a story that will have a happy ending," Mr. Gates said.

But both he and Mr. Clinton said the road to that goal would be rocky until scientists developed a vaccine or cure.

For example, Mr. Gates said, a simple drug therapy can help most infected mothers avoid passing the AIDS virus to newborns. But, in part because of stigma, poor countries are unable to provide that treatment for an overwhelming majority of pregnant women.

Mr. Gates told conference participants that grassroots support was needed to maintain and increase United States donations. But he said that "on the prevention front, things are far more complicated," in part because "education does not change behavior as much as we'd like."

Efforts to develop a microbicide - gels or creams that could be inserted vaginally or rectally to block H.I.V. infection - have been disappointing. For example, a large trial in 2000 showed that one microbicide was unsafe when it was expected to show effectiveness.

But Mr. Gates expressed hope that the investments that the Bill and Melinda Gates Foundation had made in microbicide research would produce at least one effective medicine in the next few years and be "a turning point in the epidemic."

As for stigma, Mr. Clinton cited China's experience in reversing its position on AIDS. "Initially, the Chinese were in denial about AIDS, and then they decided they wouldn't be, and they turned on a dime," he said.

Government ministers in China shook hands with an AIDS activist for the first time, the premier had AIDS activists in his office, and then the president of China visited people on their deathbeds in hospitals.

Both Mr. Clinton and Mr. Gates cautioned that antiretroviral drugs to fight H.I.V. could not just be dropped into poor countries if there were no workers trained to deliver them and monitor therapy. The ability to train such workers varies by country, they said.

Mr. Clinton said he found it difficult to imagine how the world would come together unless something serious was done about AIDS.

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