BANGKOK, Thailand – The largest AIDS conference to date ended Friday with delegates highlighting soaring infections among women and warning of explosive epidemics in Asia and Eastern Europe.
Nelson Mandela (search), who turns 86 on Sunday, took the podium at the closing ceremony and declared he "cannot rest" until the world turns the tide against the HIV pandemic.
"History will surely judge us harshly if we do not respond with all the energy and resources that we can bring to bear in the fight against HIV/AIDS," the former South African president told the 15th International AIDS Conference (search).
Much of the six-day gathering focused on the politics of getting more lifesaving antiretroviral medicine to HIV-infected people in the developing world, especially in Africa.
The United States — the most generous donor nation on AIDS — came under intense criticism for its drug-funding policy and for tying much of its money to programs that emphasize abstinence over the use of condoms, the most trusted HIV-blocking method.
Mandela joined U.N. Secretary-General Kofi Annan (search) in delivering vigorous calls for more donations to U.N. efforts to fight the disease. Software magnate Bill Gates' foundation and the European Union announced new grants totaling $102 million.
This year's conference, drawing nearly 20,000 scientists, policy-makers, HIV-infected people and their advocates, not only boosted awareness of HIV but raised the accountability of world leaders, said Mechai Viravaidya, the most prominent AIDS campaigner in host country Thailand.
"The message is clear: Leaders watch out. We are going to come after you. The media and the people who are involved are going to say, `What's your commitment?'," Mechai told The Associated Press.
The most-anticipated breakthrough on AIDS, a vaccine, remained elusive. Experts called for urgent work on alternatives for prevention in the interim, including HIV-killing gels to protect women against men who refuse to use condoms.
"Gender inequality is driving new infections among women and girls like never before," Irene Khan, secretary-general of Amnesty International, told the last full session of the conference.
An estimated 38 million people are infected with HIV, 25 million of them in sub-Saharan Africa.
Experts say nearly half are women and their infection rates are climbing much faster than men's in many regions. In the Caribbean, for example, 70 percent of new infections are in women.
In Asia, 7.2 million people are infected, and epidemiologists warned that Asia and Eastern Europe face a critical phase with infections spreading from injecting drug users to sex workers, whose clients can launch the virus into the broader community
Prostitution is considered the main engine driving the spread in Asia, many experts said, warning that epidemics could explode unless condom use is boosted.
"Now, hopefully, the painful lessons that we have learned will put us in better stead for the Asian experience," said Dr. Anthony Fauci, director of U.S. National Institute for Allergy and Infectious Diseases.
Since the last AIDS conference in Barcelona in 2002, the number of people being treated for the disease has doubled in the developing world to 440,000. At the same time, 6 million people died from the virus and 10 million more became infected, WHO figures show.
Only about 7 percent of the 6 million people in poor countries who urgently need antiretroviral treatment are getting it, and there has been no overall improvement in the proportion of people getting treatment and prevention versus the total number infected, the United Nations says.
"We are all going to walk away from this meeting knowing that we have a long way to go with regard to access, because the countries that have the greatest need still have the least access," Fauci said.
Despite grim statistics and warnings, the conference ended with some optimism.
"I truly believe that, for the first time, there is a real chance that we will get ahead of this epidemic," said Dr. Peter Piot, executive director of the U.N. AIDS agency.
In 2002 President Bush introduced a $15 billion AIDS-fighting plan, mainly directed toward 14 countries in Africa and the Caribbean, plus Vietnam. Critics say the United States should instead give much of that money to the U.N.-sponsored Global Fund, which reaches 128 countries.
The U.S. money comes with strings attached — one-third of that earmarked for prevention goes to abstinence-first programs. Also, the money can only buy branded drugs made by companies in rich countries, shutting out cheaper generic medicines from countries such as India, Brazil and Thailand. Global Fund money can go toward generics.
Activists held daily protests against Bush's stance on AIDS, shouting slogans such as "Bush lies. Condoms save lives."
The next conference is to be held in Toronto in 2006.