Voice of America - July 5, 2004
Joe De Capua

The 15th International AIDS Conference is underway in Bangkok, Thailand. The theme of the conference is "Access for All," referring to the availability of anti-retroviral drugs for those in need.

A new initiative is being launched in Bangkok to help make that happen. The free treatment initiative is spearheaded by Alan Whiteside, the director of health economics and HIV/AIDS Research at the University of KwaZulu-Natal in Durban.

He says the first goal is to get economists more involved in the fight against the pandemic. Professor Whiteside said economists don't have a clear knowledge of what's happening with regards to this epidemic. He said because it is such a long term event, "we really can't see the effects it's going to have on something as simple as macro-economic growth, never mind more complex issues like society, development and so on. So that's the first area of concern." Professor Whiteside said,"The second is there is going to be treatment out there. And what we need to do is set the parameters under which it should be provided. So we're calling for free treatment, but with certain provisos."

Besides economists, the free treatment initiative also aims to attract public health specialists and policymakers. Mr. Whiteside says participants have been working on a draft declaration - a final version of which is to be presented in Bangkok. It calls for universal acceptance of the principle that free anti-retroviral treatment should be provided to those who need it but cannot afford it. Mr. Whiteside said, "Adopting a principle is very easy and we have many examples of that from international agencies and governments - where you adopt principles. It's putting it into practice that is complicated. So, I don't see any difficulty in adopting a principle."

Professor Whiteside said the declaration calls for anti-retroviral drug programs that are equitable and effective. He said, "If we look at the situation, the reality is even if we adopt the principle of free treatment we know we're not going to get it to everybody who needs it. He said, "If we adopt the principle of free treatment then we're not saying that those who can afford it - for example, people on medical assistance or people working for major multi-national companies - shouldn't pay for it. It really is a minefield, but what we were trying to do is set out some basic principles in this declaration."

Mr. Whiteside said the declaration is meant to, first, "assist UNAIDS and the WHO in adopting guidelines in free treatment. Next, lead the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank and others to adopt the principle. Provide economic and public health evidence for policymakers. And finally assist activists and others in their advocacy towards their governments in obtaining free treatment."

Professor Whiteside said he hopes to accomplish several things over the long term. He said "The first thing is to put it on the table - to say that these are principles that we think we should support and do you agree with them?" He said the second thing is to start a realistic debate. He added, "I think it's high time we engage in a realistic debate. There's been some fairly sterile discussion about whether or not treatment should be provided at all and I think we've moved beyond that. So, I want to keep that momentum up."

And then the third thing is to try to set the agenda that economists and public health specialists should be looking at. He said, "For example, we have to be realistic. In most countries we won't treat everybody. So, who should get priority and how are we going to make those decisions?"

As for the Bangkok AIDS conference itself, Professor Whiteside says he expects it will draw attention to the AIDS pandemic in Asia the way the Durban conference did for Africa. Professor Whiteside is co-author of the book "AIDS in the 21st Century."

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