Former South African President Nelson Mandela and former U.S. President Bill Clinton today called on world leaders to recognize AIDS as a threat to international peace and economic stability.  Speaking at the close of the 14th International AIDS Conference in Barcelona, Spain, Clinton said, "One hundred million AIDS cases mean more terror, more mercenaries, more war, destruction and the failure of fragile democracies."

Clinton called on donor governments to "figure out what our share is" of the $10 billion the United Nations says is needed annually to fund global programs to combat HIV/AIDS.  The United States should increase its spending by nearly $2 billion, he said, an amount that would be "less than two months of the Afghan war, less than 3 percent of the requested increase of defense and homeland security budgets" (Emma Ross, Associated Press, July 12).

"If we don't do it," Clinton warned yesterday, "we will be spending far, far more than that to clean up the mess of this humanitarian tragedy."

Clinton yesterday expressed regret about not doing more to combat HIV/AIDS when he was president and urged leaders in the developing world to speak out strongly and develop national action plans to stop its spread (Lawrence Altman, New York Times, July 12).

Clinton, who spoke yesterday at a roundtable discussion with the leaders of several developing countries, encouraged poor countries to continue their efforts to seek generic anti-retroviral drugs.  Following negotiations between the World Health Organization and the pharmaceutical industry Wednesday, El Pais reports the WHO was able to reach a pact with six major drug companies to reduce by 80 percent the prices of anti-retroviral drugs for 30 countries (Costa-Pau/Noguer, El Pais, July 12, UN Wire translation).

Mandela today called AIDS "a war against humanity ... the requires the mobilization of entire populations."  He called for access to anti-retroviral medication "for all those who need it, wherever they may be in the world, regardless of whether they can afford it" (Ross, AP).

The six-day conference, which was attended by 15,000 doctors, public health officials, researchers and nongovernmental organization representatives, is the largest conference since AIDS was detected 21 years ago (Richard Ingham, Agence France-Presse, July 12). 

Germany contributed $50 million more to the Global Fund, bringing its pledges to $200 million, the Global Fund announced today.  The promise was made by German Minister for Economic Cooperation and Development Heidemarie Wieczorek-Zeul yesterday, the fund said in a statement.  The fund has $2.1 billion in commitments so far, a quarter of which has come from the United States, AFP reports.  The United Nations has a target of raising $10 billion to fight HIV/AIDS from all sources, including the fund, by 2005 (AFP, July 12).

A new joint Zambian-U.S. study has concluded that sexual activity among Zambian teenagers has decreased in the last five years following a U.S. Agency for International Development-supported youth campaign that promoted fidelity, abstinence and condom usage.  Leaders from some developing countries were skeptical, however, that abstinence messages are effective in preventing sexual activity.

"Millions and millions of young people are having sexual relations," said Paulo Roberto Teixeira, the AIDS program coordinator for Brazil's Health Ministry.  "We cannot talk about abstinence," he said.  "It's not real.  This is a big and very risky initiative."

The controversial study found that in the early 1990s, 41 percent of people in Zambia were having premarital sex, while by the end of that decade the number had fallen to 14 percent.  The study also revealed that the percentage of HIV-infected girls aged 15 to 19 in the country had fallen from 28 percent to 15 percent over the last five years.  According to AID senior HIV/AIDS adviser Paul De Lay, the results of the study are "the first symbol that the epidemic is turning around in Zambia" (Jay Donnelly, Boston Globe, July 12).

To read more about the AID-supported "Helping Each Other Act Responsibly Together" program in Zambia, click here.

Doctors and social workers from the former Soviet Union and Eastern Europe told delegates to the conference earlier this week that needle exchanges, law reforms and an end to the stigma surrounding drug addiction are all necessary to stem the explosive growth of HIV/AIDS in the region, which the latest Joint U.N. Program on HIV/AIDS report said is home to the "fastest growing epidemic in the world."  According to AFP, 90 percent of infections in Russia and 75 percent in Ukraine are among intravenous drug users.

According to International Harm Reduction Development Director Kasia Malinowska-Sempruch, the most important weapon against the threat of HIV in the region is to fight drug addiction without prejudice so that the problem is dealt with openly.  Her program, which is an initiative of billionaire philanthropist George Soros' Open Society Institute, is now promoting programs under which addicts can exchange old needles for clean needles -- an idea also backed by the WHO -- and the usage of methadone to gradually wean drug users away from heroin.  But one of the key challenges is contemporary thinking in society, she added.

"Rigid and repressive drug policies in many countries mean that such programs are few and far between," she said.  "We've heard reports of parents in Central Asia watching their children die of overdoses, so afraid of police harassment of the entire family that they will not bring them to a hospital" (Richard Ingham, AFP, July 11).

Exhibits at the conference included an information booth run by the nongovernmental Chinese Foundation for the Prevention of Sexually Transmitted Disease and AIDS, which sought to highlight the nation's efforts to stem the disease in the wake of U.N. warnings of an impending epidemic of unprecedented proportions.

The exhibit was created to "give the people of the world a window of understanding onto China's work in combating HIV/AIDS," according to the group's secretary general, Xu Huadui. It included information on the Chinese State Council's 12-year plan to control the virus.  Drafted in 1998, the plan calls for establishing educational campaigns, ending infection through blood transfusion, controlling HIV transmission through drug abuse, lowering sexually transmitted spread of the virus and raising the standard of treatment by 2010.

Xu said the government hopes to keep the nation's infection rate within 1.5 million, adding that if the State Council plan is not fully implemented, China could see 10 million HIV cases by 2010.  This compares to the current total of 40 million cases worldwide (Sheng Suyan, Xinhua News Agency, July 11, UN Wire translation).

Europa Press reports that a group of HIV-positive delegates complained yesterday in an open letter to International AIDS Society President Stefano Vella of the treatment they received at the Barcelona conference and the difficulty they and others have had in obtaining visas from Spanish embassies to attend the event (Europa Press, July 11, UN Wire translation).

Meanwhile, the co-presidents of the next international conference on AIDS, to be held in Bangkok in July 2004, announced yesterday that their main goal is that it be more human- and less science-oriented than the Barcelona conference.  "We want the community (of those infected with HIV) to play an important role in the conference," said one of the co-presidents, Mechan Viravaidiya.  "AIDS has more to do with people than with scientists" (Europa Press II, July 11, UN Wire translation).

In other conference news, Sesame Street announced at Barcelona that it will soon introduce its first HIV-positive Muppet character to the children of South Africa, the Sydney Morning Herald reports.  According to Sesame Street Vice President Joel Schneider, talks are also under way to introduce the U.S. audience to an HIV-positive character (Sydney Morning Herald, July 12).

Click on BBC World Update to listen to an interview with Mandela about the conference (Note: You may have to download free software to access this audio link).  For a Washington Post article on an innovative treatment program in Haiti, click here.

For more coverage of the conference by UNAIDS, click here.  For the Kaiser Family Foundation's special extended coverage of the conference, including webcasts of the sessions, click here.