OneWorld.net (U.S.)

WASHINGTON, D.C., Jul 8 (OneWorld) - With some 15,000 delegates and representatives of non-government organizations (NGOs) gathering in Bangkok this week for Sunday's opening of the 15th International AIDS conference, the Bush administration is under pressure to increase aid to a key global agency and to stop kowtowing to the interests of the big pharmaceutical companies.

Apart from the continuing spread of the disease, particularly in Asia and Eastern Europe, activists are most concerned about the future of the Global Fund to Fight AIDS, Tuberculosis and Malaria, a multilateral initiative created three years ago to mobilize and quickly disburse billions of dollars a year to programs proven to prevent, contain, or treat HIV/AIDS.

Starved for funding, however, the Global Fund is running out of money and may not have enough on hand to fund any new programs until 2007, according to the latest estimates. Activists say Bush, whom they blame for the shortfall, should commit significantly more aid to the Fund on an urgent basis - at least US$1.2 billion next year compared to the mere $200 million he has requested from Congress.

"The Global Fund, the world's most promising AIDS program, is now in jeopardy, and the US bears much of the responsibility," said David Bryden of the Global AIDS Alliance (GAA), one of many U.S. NGOs that is sending delegations to Bangkok.

In addition, activists want Washington to immediately end all restrictions it has placed on its aid recipients and the U.S. Agency for International Development (USAID) regarding the purchase of generic life-sustaining AIDS drugs approved by the World Health Organisation (WHO) and to drop provisions in new trade agreements that require poor countries to import brand-name drugs for at least five years before importing cheaper generics or producing their own.

The Bush administration is still insisting that only brand-name AIDS drugs approved by the U.S. Food and Drug Administration (FDA), most of them manufactured by big U.S. pharmaceutical companies, can be bought by beneficiaries of U.S. aid, despite the fact they are as much as five times more expensive as their generic equivalents manufactured in poor countries.

''President Bush is a drug company puppet'', said Asia Russell of Health Global Access Project (Health GAP). ''He plans to force millions of people with HIV/AIDS to accept higher pill burdens and waste tax money to create a slush fund for Big Pharma. If Bush would use the WHO's quality-assured generics, we could treat four times as many people in need''.

Indeed, the latest statistics, released earlier this week by UNAIDS, shows that the need has never been greater.

It found that nearly three million people died from AIDS-related causes last year, some two thirds of them in Africa. At the same time, however, another five million more people worldwide were infected with HIV, the virus that causes AIDS. And while the epidemic appears to have stabilized in Africa, it is spreading quickly elsewhere.

"We are now entering the globalisation phase of the epidemic," said Peter Piot, UNAIDS director said Tuesday. "So far the epidemic has been largely in sub-Saharan Africa. But now one in four new infections is being reported in Asia, and the fastest growing epidemic is in Eastern Europe."

UNAIDS also found that five to six million people need HIV treatment in low- and middle-income countries, but only seven percent, or just 400,000 people had access to the life-preserving drugs by the end of 2003. As a result, the number of children under age 18 who have lost one or both parents to the disease is rising steadily: an estimated 15 million worldwide, 12 million of them in sub-Saharan Africa.

UNAIDS also estimates that at least $12 billion will be needed in 2005 to effectively fight AIDS in developing countries - more than twice what is likely to be spent this year. The agency said $20 billion will be needed by 2007 to contain the epidemic.

"The latest statistics make clear that the world is not even treading water in this fight," said Paul Zeitz, GAA's executive director. "Rather, the countries affected are sinking fast and the disease is poised to devastate entire regions. We are missing our chance to get ahead of the virus before it brings what we have seen in Southern Africa - where adult infection rates are 25 percent or more - to the rest of the developing world."

To do so, according to Zeitz and other activists, support for the Global Fund, which is providing grants to 129 countries currently, must be increased.

Bush, whose five-year, $15 billion 'President's Emergency Plan for AIDS Relief (PEPFAR) was initially greeted enthusiastically when it was first announced in January, 2003, has tried to restrict U.S. contributions to the Global Fund to only $200 million a year.

While the administration has defended its tight-fistedness towards the Fund on the grounds that it must still prove that it is effective, most observers say it is motivated by pressure from special interests, including the Christian Right and the pharmaceutical industry, concerned about its support for a range of reproductive health services and its purchase of WHO-approved generic drugs, respectively. In addition, the administration has shown a more generalized hostility toward multilateral institutions over which it does not exercise direct control, despite the fact that the Global Fund's chairman is Bush's Health and Human Services Secretary, Tommy Thompson.

As a result, most of the aid appropriated by Congress for PEPFAR has supported bilateral programs, and roughly a third of the total has been earmarked for programs that promote abstinence, a strategy that most public-health experts consider relatively ineffective.

Congress has taken a significantly more generous view. It increased Bush's 2004 PEPFAR request from $1.8 billion to $2.4 billion, and, instead of the $200 million requested by Bush for the Global Fund, it approved a total of more than $500 million for the agency this year.

For fiscal 2005, which begins October 1, however, Bush has again requested only $200 million out of a total of $2.8 billion for his PEPFAR program - a 60 percent cut from the 2004 contribution.

Because other wealthy donor nations look to the U.S. in determining their own contributions, the result could be catastrophic, unless Congress significantly increases the amount, even beyond the $500 million it appropriated last year, according to AIDS activists.

European countries are currently contributing more than half of the Global Fund's resources, but are unlikely to provide substantially more if Washington fails to do so. "The world is looking to the U.S. to reprioritize global cooperation over unilateralism," said Zeitz.

Indeed, Bush, who promised to put two million people on life-saving drugs when he launched the PEPFAR program, has so far only provided treatment to roughly 20,000 in the 14 African and Caribbean countries that are eligible to benefit from it, according to GAA estimates. The Global Fund, on the other hand, is currently treating as at least that many in just one country, Rwanda.