Anti-HIV tactics for women urged

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Gateses pledge more money to aid prevention efforts
August 14, 2006

TORONTO -- The world's wealthiest couple issued an urgent call last night to develop new ways to prevent the march of AIDS -- and pledged to devote more of their riches to the cause.

Bill and Melinda Gates, affirming their presence at the vanguard of the global HIV war, told delegates at the 16th International AIDS Conference that with a reliable vaccine not on the horizon, prevention efforts must be reinvigorated.

And prevention must focus on more than condoms, they said, with strategies to allow women to better control their exposure to a virus that infected 4.1 million people globally last year.

``We're going to have to do a much better job on prevention to stop HIV," Bill Gates said during a news conference. ``We hope this can be the next big breakthrough."

``A woman should never have to rely on her partner to save her life," he said, adding that priority should be given to developing creams, gels, or pills that women could use to protect themselves.

Last week, the Bill and Melinda Gates Foundation announced that it was giving $500 million over five years to the Global Fund to fight AIDS, Tuberculosis, and Malaria, a private organization with headquarters in Geneva.

The money will pay for powerful medications and other medical care in swaths of the world that have disproportionately borne the burden of the epidemic, especially Africa and Asia.

Those drugs have already changed the course of the AIDS epidemic in the past decade, turning a disease once regarded as a death sentence into a condition capable of being treated for decades.

``It is now time we move from crisis response to a long-term sustainable response," said Dr. Peter Piot, who presides over the UN's AIDS division.

But the scientific triumph of AIDS drugs, Bill Gates told delegates, came with a staggering price tag.

Even with dramatically lower prices for AIDS pills in the developing world, Gates estimated that it would cost $13 billion a year to pay for treatment for the 40 million infected people across the globe.

``You quickly see it's very difficult to do what morality requires -- treat everyone with HIV -- unless we dramatically reduce the number of new infections," Gates said.

So the Gateses exhorted governments, private donors, and scientists to devote more money and energy to novel methods to prevent transmission of HIV, the virus that causes AIDS.

In a sense, that call to action had a back-to-the-future appearance about it. When the epidemic dawned a quarter of a century ago, prevention was the only weapon in the arsenal of doctors and public health specialists.

But despite 25 years of messages about how to avoid catching the virus, infection rates have remained stubbornly constant.

In the United States, for example, about 40,000 people year in, year out are diagnosed with the AIDS virus.

Human immune deficiency virus, which causes AIDS, ``is the planet's enemy number one," said Dr. Mark Wainberg, cochairman of the conference.

And stopping HIV, specialists said yesterday, requires spending more on prevention strategies that could involve, for example, microbicides -- gels or creams used by women to block the virus. Right now, 16 compounds are in various stages of development.

Without specifying an amount, the Gateses said they would spend more of their fortune to underwrite prevention campaigns. But Melinda Gates said the cost of those efforts cannot be shouldered by philanthropists alone.

``We absolutely need more governments to come in and play a role," Melinda Gates said.

As the epidemic enters its second quarter- century, scientists and government policy makers last night received a gentle admonition from an Indonesian woman whose entire life has been framed by the disease.

``If you do not involve people living with HIV/AIDS, it means nothing," Frika Chia Iskandar said. ``It's people like me you want to reach, you want to touch."



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