PîïïïTïTrTnews
he big story at the 14th Interna
tional A ID S Conference held
July 7 to 12 in Barcelona, Spain,
was not a surprise. It is that less
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than 2 percent of the 40 million
HIV-positive people in the world have access to
the drugs that keep them from dying of AIDS.
Bill Clinton made several appearances dur
ing the confab, presenting his recipe for ending
the AIDS epidemic. The former U.S. president
serves as advisory hoard chairman of the Inter
national AIDS Trust.
“My advice,” Clinton told the 15,000 dele
gates, “is push every country you can to make
their deals with the drug companies. If the deals
are unsatisfactory, go to Brazil or India— the
U.N. is certifying those drugs. Then come to the
rest of us and say, ‘OK, this is what we need:
Here’s what we need for medicine, and here’s
what we need for prevention.’ ”
Brazil and India circumvent company
♦patents by producing and exporting generic
AIDS drugs at a fraction of the cost of the
brand-name products. “Barring some nuclear
war, more people are going to die from AIDS in
the next three years than from anything else,"
Clinton said.
About 20 million people around the world
have died of AID S to date, according to the
United Nations. By 2020, 68 million more may
be dead. Even with negotiated price reductions
in some Third World nations, the anti-retroviral
dmgs— each one patented and produced by only
one company— still cost way too much.
“We are only at the beginning of the AIDS
epidemic,” UN AIDS director Peter Piot said.
“Collectively, we have grossly, grossly underesti
mated how bad this was going to b e.... It is by
far the biggest epidemic that humanity has
known in absolute terms.”
E pidemic P roportions
Barcelona conference: AIDS is out of control
by Rex Wockner
T reatment
Bill Clinton tapes an M T V special during the 14th International A ID S Conference on July 11
in Barcelona, Spain
the new Global Fund to Fight AIDS, Tubercu
losis and Malaria; shortchanging the U.S. AIDS
Drug Assistance Program; blocking needle-
exchange programs; and “attacking science-
based prevention programs that talk frankly
about sex and supporting abstinence-only pre
vention programs.” Protester Asia Russell said,
“The truth is, we know what he was going to say,
and we’re tired of his lies.”
U.N. officials and Others working on the
Global Fund agreed with the protesters on all
points. Columbia University economist Jeffrey
Sachs, an adviser to U.N. Secretary-General
Kofi Annan, said the Bush administration suf
fers from “utter confusion” on AIDS issues, lack
ing even a plan.
The United States has pledged $500 million
to the Global Fund, but officials say the nation’s
fair share would be $2.5 billion of the total $10
billion yearly goal. Thompson said the U.S.
contribution is a quarter of all the money the
fund has raised so far. Officials replied that when
the United States didn’t ante up its fair share,
other nations followed suit and didn’t pay what
they should, either.
Protesters pointed out that as a percentage of
their gross domestic products, Sweden has con
tributed seven times more and Rwanda has con
tributed 10 times more than the United States.
Just hours after the conference ended July 12,
the Senate passed a measure to increase U.S.
P rotests
I undreds of protesters staged a colorful
i . I march outside the conference demanding
universal access to cheap, generic AIDS drugs,
including in wealthy nations, where the yearly
price tag for an antiviral cocktail is $12,000 to
$ 15,000, a serious strain on health care budgets.
On day three of the conference, about 100
noisy protesters— with support from much of
the audience— prevented U.S. Health Secretary
Tommy Thompson from being heard when he
delivered his address. They chanted, blew whis
tles and shouted— a scene reminiscent of the
1990 A ID S conference in San Francisco.
Thompson persevered to the end despite the
deafening din.
The protesters accused President Bush’s
administration of failing to give its fair share to
contributions to the Global Fund; the bill now
must be reconciled with one the House
approved.
Spanish Health Minister Celia Villalobos
got a reception similar to Thompson’s when she
tried to address the opening plenary session. No
one heard her because several hundred delegates
screamed and blew whistles throughout her
speech.
They were upset that up to 100 delegates
were denied visas to attend the conference by
Spanish embassies and consulates in several
nations, including South Africa, Sri Lanka and
Yugoslavia. They also said Spain has budgeted
only for 21 percent of its promised contribution
to the Global Fund.
HIV T ransmission
new study revealed that many young U.S.
gay men are bareback ing and that most
who have become HIV-positive as a result do
not know they are infected. The research was
conducted by the Centers for Disease Control
and Prevention at gay bars and other meeting
places in several cities. They interviewed 5,719
men younger than 30, then drew their blood.
A total of 573 of the men tested positive, and
440 of them didn’t know they were positive.
Most, in fact, thought they were negative and at
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low risk for HIV infection. About 91 percent of
the blacks, 70 percent of the Latinos and 60 per
cent of the whites who were positive didn’t
know it.
A spokesman for the Washington, D.C.-
based national lobby group AID S Action said a
big part of the problem is barebacking— gay
men deliberately not using condoms during
casual sexual encounters.
“There is the whole notion that AIDS is
over in the United States, that it’s not a problem
anymore,” said Scott Brawley, public policy
director. “Prevention messages are not work
ing.... We have a whole generation of people
under the age of 30 that don’t remember the
AIDS epidemic, that think it’s nothing more
than, ‘Hell, you take a couple of pills and you’ll
be fine.’ ”
Brawley had no suggestions on how to slow
the barebacking trend. “My honest response, as a
gay man, is that things are going to have to get
worse again before they’ll ever get better,” he said.
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new class of drug will hit the market with
in a year. Fusion inhibitors, also called
entry inhibitors, block HIV earlier in the repli
cation process than any of the 16 drugs now
available, preventing an immune system cell
from becoming infected in the first place.
The new drug— made by Roche and the
U.S. biotech firm Trimeris— is called T-20 or
enfuvirtide. It has succeeded in reducing HIV
viral load to undetectable levels in many people
who had become resistant to all currently avail
able drugs, which are protease inhibitors or
reverse-transcriptase inhibitors.
T-20 will be shockingly expensive— $10,000
to $12,000 a year, according to reports— and
must be injected rather than swallowed. Still,
veteran AID S researcher Robert Gallo, who co
discovered
HIV,
predicted
fusion/entry
inhibitors soon will replace “toxic” protease
inhibitors.
“The inhibitors of viral entry will be the
most important new advances,” he said. “My
guess would be in two or three years, the pro
tease inhibitors will go away. They will be taken
over by viral entry inhibitors and by more intel
ligent use of reverse-transcriptase inhibitors.”
Human trials will begin this year in the
United States and Italy on another possible new
treatment— therapeutic vaccines. The vaccines,
which are rubbed into the skin, might allow
HIV-positive people to go off their meds period
ically or to take fewer drugs, researchers said.
The vaccines work in monkeys, stimulating the
white blood cells that destroy HIV-infected
cells, j n
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