Research expected to set a major part of the agenda for the Barcelona conference shows that it is possible to avoid a grim prognosis offered early last week in a UNAids report which indicated that the disease has far surpassed the worst predictions of its spread set out a decade ago.
A report published yesterday in the Lancet medical journal argues the case for a massive scale-up of resources and prevention measures, which it says could help the world avert 29 million new HIV infections expected to come by 2010.
"We can very substantially alter the course of the epidemic," said Bernhard Schwartlander of the World Health Organisation and one of the Lancet study's authors. "None of this is inevitable."
Countries that have already implemented programmes similar to that proposed by the Global HIV Prevention Working Group, such as Thailand, Brazil and Uganda, have stabilised the spread of the virus. But Uganda, a country with the most successful HIV-prevention programme in sub-Saharan Africa, paints a sobering picture of the challenges ahead. Only 5% of all HIV-infected pregnant women in Uganda have this year received Nevirapine, a drug that prevents transmission of HIV from mother to child in 50% of cases.
But availability of the drug is not the limiting factor, said David Serwadda, of Makerere University's school of public health. Doctors cannot distribute Nevirapine because much of the HIV-infected population lives in rural areas and cannot access the urban treatment centres, he said.
'Over 60% of pregnant women live at home as opposed to at health centres,' Serwadda said.
'We are having to find suitable ways to deliver Nevirapine to them. The drug is increasingly becoming available, but there are other challenges we need to overcome.'
When Dr Badara Samb, director of the World Health Organisation's Africa division on Aids, addresses the Barcelona conference via satellite tomorrow night he will demand the international community starts closing the gap in Aids funding inequities between Africa and the West by dramatically upping resource allocations to Africa.
'We have over 40 million people living with HIV/Aids and if this solidarity is not here, it means that nearly 40 million people will die,' he told the Sunday Herald.
Samb believes the money needed is rattling around somewhere, untapped in the world's coffers. 'Come on,' he said, 'that money is in the planet. We are living in a global world. There's been a globalisation of the HIV epidemic. It is at everybody's door.'
Last June members of the United Nations General Assembly Special Session on HIV/Aids met in New York to take the first steps in forming a multi- government compact to erode the social and economic factors that leave nations vulnerable to HIV infections -- economic insecurity, underdevelopment, poverty, lack of empowerment of women, lack of education, social exclusion, illiteracy, discrimination, lack of condoms, and sexual exploitation.
The session closed with members promising to identify and begin to address these issues by 2003. A year later, 30 nations now have prime ministers or presidents that sit on a UNAids advisory board.
But critics say the talk has succeeded in setting lofty goals but inspired little action, as developing nations still bear the brunt of infections and receive a fraction of treatment and prevention methods accessible to wealthier nations in the West.
'It is most important that we get more groups from around the world working together for access to care for treatment in developing countries,' says Joep Lange, president of the International Aids Society and one of the conference's key organisers. 'The situation is definitely not improving. We will never have a stable world if this action isn't taken.'
Uganda, a country with the most successful HIV-prevention programme in sub-Saharan Africa, paints a sobering picture of the challenges ahead. Only 5% of all HIV-infected pregnant women in Uganda have this year received Nevirapine, a drug that prevents transmission of HIV from mother to child in 50% of cases.