San Francisco Chronicle - Monday June 5, 1989
David Perlman, Chronicle Science Editor

The opening session also heard a plea for swifter research and a stronger focus on AIDS prevention throughout the Third World from Zambian President Kenneth Kaunda. Kaunda spoke emotionally of the death from AIDS of his oldest son three years ago and moved his entire audience to applause when he declared passionately: "Our own extended family stood by him as he died, and now we know the best way to mourn him is by fighting AIDS."

Soft Nuclear Bomb

Applause resounded again as Kaunda warned that if the world's educators fail to prevent the epidemic's spread and scientists fail to find a cure, then the disease will become a "soft nuclear bomb - silent and destructive and threatening the human race with extinction."

The African leader's speech - as well as the entire opening session attended by a crowd of nearly 6,000 - was delayed for more than an hour by demonstrations. More than 350 Canadian and American AIDS protesters pushed their way into the vast conference hall and occupied a mass of center seats, assailing what they said was the slow pace of research.

New York playwright Larry Kramer, an ACT-UP organizer, said the protests reflected growing anger among gay men about the glacial pace of testing AIDS drugs. "The affected community is getting angrier and angrier as we hear more and more about promising developments that are supposed to be just around the corner," Kramer said.

In his forecast of the epidemic's future, Mann warned that the epidemic is spreading fastest throughout the Third World, where myths persist and social, political and economic forces block adequate prevention efforts.

Statistical History

At least a third of all new AIDS cases that will strike people in the coming decade could be prevented, he said.

In his report, Mann touched on the epidemic's history during the first eight years its existence has been known: Between 5 million and 10 million people have been infected worldwide, although most have not developed the disease. He said that half were in Africa, 40 percent in America, less than 10 percent in Europe, and only a tiny fraction in Asia and the Pacific Islands. But a foreboding change is already under way. Mann said the epidemic is exploding in countries such as Thailand, where viral infections have multiplied twentyfold among intravenous drug users and more than tenfold among prostitutes.

In West Africa, Mann said, the World Health Organization's surveillance teams have found the epidemic spreading swiftly in many of the continent's largest cities.

In one West African nation, the Ivory Coast, the infection rate has multiplied from barely 1 percent less than two years ago to at least 4 percent today.

In Brazil, a "new urban epidemic of cocaine injection" has caused a threefold rise in AIDS infections, Mann said, and in Spain and Italy drug injections now account for more than 60 percent of all AIDS cases.

By the turn of the century, Mann said, at least 6 million people will either have the disease or have died from it.

Developments The scientists here are set to report on thousands of new developments in their quest for an understanding of the still mysterious mechanisms by which HIV, the human immunodeficiency virus, causes the disease. They are reporting on new drugs and potential vaccines being tested in the laboratory and in animal and human trials, but they have yet to find either cures or testable vaccines.

"The future," Mann said, "will require all the skill and all the dynamism of international science to face this issue."

The demonstrations yesterday - by members of Canada's "AIDS Action Now" and New York's "ACT UP" - began while the delegates were busy registering for the conference, which is concentrating on 3,000 reports of progress in treatment and research. Nevertheless, hundreds of protesters, many of them people with AIDS, picketed Montreal's huge Palais des Congres, paraded inside the hall with protest signs and shouted slogans charging the world's medical establishment with inaction.

The organizations also issued a "Montreal Manifesto" urging that because of the available drugs that can at least slow the onslaught of some of the deadliest AIDS infections, the disease should now be treated as a "chronic manageable condition." The groups' treatise also demanded that mandatory AIDS testing be outlawed. It branded as "inherently unethical" the use of controlled "placebo" trials where new drugs are tested in human patients against dummy drugs that intentionally have no effect.

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