"We are facing a major challenge in terms of funding because the global economic downturn has got a lot of governments looking hard at their budgets, and some doing decreases in the kind of aid that goes for global health, and AIDS in particular," said Microsoft co-founder Bill Gates, who now runs a philanthropic foundation that bears his and his wife's names.

That very topic will be widely discussed at the 18th international conference on AIDS in Vienna next week, said Gates, who will deliver a speech at the meeting.

Dr Anthony Fauci, head of the US National Institute for Allergy and Infectious Disease (NIAID), said the economic crisis couldn't have come at a worse time for the fight against AIDS.

"There are not enough resources to meet the demands of people who need treatment and prevention," he said, adding that the sharp dip in funding to fight AIDS has hit "just as we are reaping the fruit of success in getting therapy and prevention to the developing world."

Some five million people in poor countries are being treated for or to prevent HIV/AIDS today, compared with just one tenth of that number six years ago.

The cost of antiretrovirals has fallen from 15,000 dollars per person per year in 2001 to 120 dollars a year today.

And the rate of infection with human immunodeficiency virus -- or HIV -- has dropped 17 percent compared to 2001, when it was at its acme.

But, said Fauci, that doesn't mean it's time to rest on one's laurels.

"Every time you treat one person, two to three people get newly infected.

"So we have the challenge of treating people who need to be treated -- and there are more and more because there are 2.7 million new infections per year -- and at the same time of preventing new infections," he said.

"We are in somewhat of a crisis and the solution to it is not particularly evident right now," he said.

Dr Julio Montaner, president of the International AIDS Society (IAS), warned of the devastating consequences if governments "don't do more in terms of the quality and quantity of care for people with HIV."

Doing nothing would "result in dire human and economic costs in the short and long term," he said.

In 2006, United Nations member states committed to achieving universal access to HIV prevention, treatment and care by this year.

But with the deadline here, the global community has failed to deliver on this pledge.

In 2009, UNAIDS estimated that 25 billion dollars will be needed by this year for the AIDS response in low- and middle-income countries. That's 11.3 billion dollars more than is actually available today.

Gates urged governments and NGOS to "apply new innovations to get more out of every dollar of funding that is available," and to focus on preventive methods that have been shown to work, such as male circumcision.

Dr Paul Zeitz, founder and executive director of the Global AIDS Alliance (GAA), said increasing infections and flat funding have left the global AIDS movement in crisis and millions of lives at stake.

In Africa, which is at the epicenter of the AIDS pandemic, the enrollment to get life-saving medicine has stopped, he said.

"Country after country is stopping enrollment," he said.

Zeitz called on world leaders to be true to their word and step up to the plate in the fight against AIDS. Among those he singled out for criticism were US President Barack Obama who during his campaign for the US presidency pledged to increase funding for AIDS more than three-fold.

Since he has been elected, nothing has been done, said Zeitz.

earlier related report
Southern Africa in circumcision drive to fight AIDS
Harare (AFP) July 16, 2010 - Thomas Mukone wonders exactly how he would tell his wife that he wants a circumcision at age 41, even with the government in Zimbabwe urging adult men to get snipped to slow the spread of AIDS.

"It's not easy to discuss this as she is bound to accuse me of promiscuity," he said. "It is a really nice programme, but how will I tell my wife that I want to go for circumcision?"

Zimbabwe has joined the growing list of countries in southern Africa that is pushing, and sometimes paying, for adult men to get circumcised, in the wake of studies that found men without a foreskin are 60 percent less likely to catch HIV.

Scientists think this is because the foreskin has more cells that are easier for HIV to infect. The findings have sparked a regional drive to make circumcision a routine party of prevention efforts.

Zimbabwe aims to have 30,000 men undergo circumcision by year end, said Owen Mugurungi, head of the national HIV prevention programme.

It's an ambitious target -- 82 men would have to get trimmed every day in a country where the medical service struggles to provide basic care.

Mugurungi said 4,000 men have taken part so far, including many in the army, and donor funding means the procedure is free for volunteers.

But convincing men to undergo the procedure requires tackling issues both complicated and intimate in the region hardest-hit by AIDS.

"In many households, the issue of circumcision is still treated with suspicion and we need to do more campaigns" to educate the public, Mugurungi said.

Trials in Kenya and Uganda have shown that circumcision, while far from being a silver bullet, dramatically reduced the number of new infections for men.

Uganda, a pioneer in HIV prevention, is currently running television and radio campaigns to encourage men to visit clinics for safe circumcision procedures.

Botswana has launched a scheme to circumcise 500,000 men -- a quarter of the total population -- by 2012.

Zambia, Lesotho and Swaziland all encourage circumcision as a matter of policy, and South Africa is running a pilot project to offer free circumcisions.

Each country is facing its own hurdles.

In some communities, circumcision is practised as a rite of passage for teenage boys. Xhosa boys in South Africa are taken to initiation schools where their foreskins are cut by traditional doctors of varying competence.

Every year, dozens of boys die of complications from the procedure, while scores more suffer amputations or gangrenous infections. That can scare off potential volunteers from safe medical circumcisions performed in clinics.

Zulus abandoned the tradition more than a century ago, but their king has proposed reviving the practice to fight HIV, with trained medical staff doing the work.

In countries like Swaziland, where HIV infects 26 percent of adults, circumcision trials began five years ago and worries have already sprung up that after the procedure men see less need to use condoms, creating a new HIV risk.

Still, the country is aiming to circumcise 80 percent of men aged 15-24 over the next four years.

The question remains, will the men participate?

Malawi has refused to look at circumcision as an option, saying it is too difficult culturally for people to accept.

"Malawi is not a circumcised country, so circumcision cannot work," said Mary Shawa, head of Malawi's AIDS and nutrition programme. "It's very difficult to implement as a policy."

Still, across most of the region billboards are sprouting up like those in Zimbabwe, which show five footballers forming a wall in front of the goal line, under the message: "Male circumcision is one of the top defenders against HIV."

Admire Murerwa, 21, a street vendor selling his wares a few metres (yards) from the sign, is not convinced.

"Yes, circumcision is right," Murerwa said. "I still think the condom is better to reduce HIV infection. Circumcision is right, but it also depends on how one behaves for you not to be infected."

earlier related report
Respect for rights can help curb spread of AIDS: HRW
Vienna (AFP) July 17, 2010 - Respect for the rights of the people most vulnerable to the AIDS virus is vital in stopping the spread of the disease, Human Rights Watch said Saturday ahead of a world conference on AIDS.

Joseph Amon, the US-based group's health and human rights director, called on governments of more than 160 countries to repeal laws criminalising sex workers, drug addicts and homosexuals.

"Only by protecting the human rights of marginalized and vulnerable populations can we succeed in ending HIV transmission and ensuring universal access to care," he said in a statement.

It was "not enough to talk about education, HIV testing, or treatment without addressing the human rights abuses that act as barriers to these services," he added.

"Governments and donors shouldn't simply preach prevention and care while ignoring the need to reduce stigma and violence, and we need to challenge them when they do."

"Laws in more than 160 countries that criminalize sex workers, drug users, men who have sex with men, and HIV exposure or transmission impede effective HIV outreach and discourage people from seeking treatment," Human Rights Watch said.

"Much like laws protecting 'morality' or 'decency', these laws also create a risk of selective or arbitrary prosecution, the group warned.

"Punitive laws that criminalize certain groups or behaviours fuel stigma and discrimination, increase the risk of HIV, and prevent HIV/AIDS services from reaching the most vulnerable populations," Amon said.

AIDS experts gather in Vienna on Sunday for the 18th International AIDS Conference since acquired immune deficiency syndrome came to light in 1981.

Expected to draw more than 20,000 researchers, policymakers and grassroots workers, it comes amid some optimism that after almost 30 years significant progress is being made towards conquering the disease that destroys the body's immune system.

However more than 33 million people live with the virus and each year 2.7 million more cases of HIV occur. Stigma, ignorance and discrimination are entrenched in many places and millions of needy people have yet to clutch the drug lifeline.

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