US rejects plea for new AIDS donation

The United States today rejected outright a call by the UN chief at the International AIDS Conference for an €824.2m contribution in 2005 to the global fund that has become the centrepiece of United Nations efforts against the disease.

“It’s not going to happen,” US AIDS coordinator Randall Tobias said, noting that Washington was already by far the world’s largest donor to the cause.

Critics say the US money comes with strings attached that can set back efforts to curb the spread of HIV – which infected five million people last year alone – and that the UN-sponsored fund best suited the needs of sufferers.

Tobias urged detractors to stop arguing with Washington over condoms and drug patents and join its war on the pandemic, which has claimed 20 million lives and left another 38 million infected worldwide since 1986, most of them in Africa.

The United States’ insistence on abstinence – rather than condoms – as a primary way of keeping out HIV, its trade policies and funding methods have drawn furious criticism at the conference, the biggest gathering ever of AIDS scientists, activists, policy makers and HIV-infected people.

Critics say a vow of abstinence is difficult to maintain and, when broken, can lead to unprotected sex, raising the risk of HIV infection that could effectively be blocked by a condom.

Tobias was jeered by protesters chanting “He’s lying, people dying”, when he was about to defend US policies in a speech at the conference.

One activist, 48-year-old Mark Milano from New York, said that when it comes to fighting AIDS, "every step of the way the US government is not doing what it should be doing”.

“It’s not working with other countries. It’s going at it alone, like it did with Iraq,” he said.

Tobias said that while the United States was not against condoms, an abstinence campaign in Uganda showed that contraceptives were not the only solution.

“At this point, perhaps the most critical mistake we can make is to allow this pandemic to divide us,” he said.

He pointed out that the United States will this year spend €1.9bn, nearly twice as much to fight AIDS as the rest of the world’s donor governments combined.

With such massive spending, there’s no need to contribute additional money to the UN-sponsored Global Fund to Fight AIDS, Tuberculosis and Malaria, he said.

Tobias’ comments were in response to a call by UN Secretary-General Kofi Annan who said he hoped that the United States would give €823.9m for 2005 alone to the Global Fund.

Stephen Lewis, the United Nations’ special envoy on HIV/AIDS to Africa, said he disagreed “profoundly” and that the Tobias stance showed “an inability to recognise the way the world most effectively works”.

The United States is carrying out a €12bn, five-year Emergency Plan for AIDS Relief, 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 Global Fund, which reaches out to 128 countries.

The money comes with strings attached – it goes to countries that support Bush’s abstinence-first policy. Also, the money currently can only buy brand-name drugs, usually American, shutting out cheaper generic medicines made by developing countries.

The Global Fund allows generic drugs, costing as little as €149.80 per person per year, while those approved under the US plan typically cost €599.10, said Joia Mukherjee, medical director of Partners in Health, which helps treat poor people in Haiti.