San Francisco Chronicle - Friday, November 17, 2006

But, worldwide, the HIV virus that causes AIDS has infected 40 million, who die at the rate of 3 million per year. The virus has jumped from sub-Sahara Africa, where 60 percent of those infected live, to gain a foothold in the "big three" nations of India, China and Russia, where nearly 2.5 billion people live.

Waging the fight had brought on an angry debate between the White House and critics here and overseas. Yet this squabble has softened, according to one prime participant, Dr. Richard Feachem, head of the Global Fund which oversees $6.4 billion in AIDS programs. Also, the rise of House Speaker-to-be Nancy Pelosi could further ease conflicts over AIDS policy, he thinks.

The United States remains the top source of AIDS money, as President Bush has shushed doubters by pledging $15 billion over 5 years. But there are strings attached, and only some 15 countries receive the aid. One of the fortunate few, Vietnam, will be showing off its AIDS facilities to Bush on his current trip to Asia.

There are signs that U.S. policy may be opening up in significant ways. The United States now permits cheaper, copycat generic drugs in place of more costly American-made pills, meaning more people can get life-extending drugs. And next year, Pelosi -- a San Francisco Democrat long familiar with AIDS policy -- could push the White House to ship more money to the Global Fund, which now receives $500 million per year.

Why is that important? Because the Global Fund, the next biggest source of worldwide AIDS money, is at work in 136 countries. It backs programs for prostitutes and drug-needle users, neither preferred by the White House. The Global Fund also doesn't harp on sexual abstinence or avoidance of condoms, two other hallmarks of U.S. AIDS policy. Its innovative "Red" program is tapping U.S. businesses to donate up to $100 million through consumer sales of clothes, cell phones and credit card use.

Feachem, a former UC San Francisco public-health professor, is under no illusions that AIDS can be easily ended, even if his fund and Washington operated in sync. The few successes to date -- such as drug treatment programs or prevention plans -- are like climbing "small hills with the mountains ahead."

The Global Fund, which also focuses on malaria and TB, provides a powerful alternative. Instead of the usual big-country approach of designating projects, it waits for ideas to come from needy nations. It doles out money as targets are met, rewarding the winners and cutting off failures or corrupt operations. Some critics believe this approach is wasteful and chaotic.

But Feachem thinks the AIDS fight needs a bold and fresh approaches. He's right -- the battle clearly calls for new thinking.
061117
SC061105

Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .