US pledges $15bn to fight Aids

The US, facing accusations of being tightfisted and of bullying developing countries in the fight against Aids, is defending its policies by citing a $15bn (€12.1bn) presidential initiative over five years to help millions of HIV sufferers worldwide.

A top US health official, speaking yesterday at the International Aids Conference in Thailand, was expected to extol Washington’s approach following criticism from UN Secretary-General Kofi Annan, the French delegation and other sceptics.

Annan urged the US to show the same leadership in fighting Aids as it has in fighting terrorism.

“We hear a lot about weapons of mass destruction, we hear a lot about terrorism. And we are worried about weapons of mass destruction because of the potential to kill thousands.

Here we have an epidemic that is killing millions. What is the response?” Annan said in an interview with the BBC in Bangkok.

In Washington, US State Department spokesman Richard Boucher rejected Annan’s criticism, saying that the $15bn that President George Bush has pledged to combat Aids is an “enormous amount” and a significant increase over what’s been spent before.

Bush’s Aids co-ordinator Randall Tobias was scheduled to elaborate at the conference today.

The US plan for HIV/Aids prevention and treatment is mainly directed toward 14 countries in Africa and the Caribbean that support the US policy of controlling HIV through abstinence, monogamy and condom use – in that order of priority.

A majority of Aids workers, however, say condoms should be the first line of defence.

The Bush plan recommends that 55% of direct aid go to treatment programs, 20% to prevention, 15% to palliative care and 10% to children orphaned by the disease.

However, treatment can be done only with antiretroviral medicine approved by the US Food and Drug Administration (FDA), which so far has only approved branded versions of the drugs.

The FDA said in May it would fast-track reviews of any applications for generic drugs so that US funds could be used to purchase the cheaper versions.

Aids advocacy groups and members of the US Congress blast the FDA process as extra bureaucracy that will delay if not discourage generics in favour of more expensive patented medicines.

Critics say it undermines the World Health Organisation, which has set its own standards for the drugs.

Yesterday, the WHO approved four more generic drugs manufactured in India for HIV treatment.

An estimated 38 million people are infected with HIV, mostly in poor countries: 25 million in sub-Saharan Africa and 7.2 million in Asia. Only about 7% of the six million people in poor countries who need antiretroviral treatment are getting it.

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, six million people died from the virus and ten million people became infected, WHO figures show.

“By these measures of human life, the ones that really matter, we have failed. And we have failed miserably to do enough in the precious time that has passed since Barcelona,” said Jim Kim, WHO’s Aids director.

Yesterday, French officials said the US was trying to bully developing countries during negotiations on free trade agreements to give up rights granted by the World Trade Organization to produce generic drugs.

In a statement read out at the conference, French President Jacques Chirac said forcing certain countries ”to drop these measures in the framework of bilateral trade negotiations would be tantamount to blackmail".

A US official denied the French allegation as ”nonsense,” saying the United States is committed to its WTO obligations.