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Of elephants and AIDS

BANGKOK, Thailand
THE INTERNATIONAL AIDS conference in this Asian capital last week mobilized scientists, drug salesmen, activists, politicians, actors, statesmen, medical doctors, and spin doctors to deal with a disease that is killing 8,000 people a day. Then one non-AIDS death caught the attention of the 20,000 delegates: A Bangkok man was stomped to death by an elephant. First reports identified the guilty elephant as one of 20 who had performed in an opening day parade at the conference center, but it was later found to have been a different beast. With AIDS, there is no mistaking what is killing millions.

More than two decades into the worst pandemic in 600 years, nothing better demonstrates how the virus still has the upper hand than the "3 by 5" goal of the World Health Organization -- 3 million patients under treatment with AIDS drugs in developing countries by 2005. With just 400,000 people now being treated, there is little chance the goal will be reached. Even if it were, it would be more than matched by the 5 million new infections every year, including 40,000 in the United States.

AIDS is winning, and it is just getting started in India, China, and Russia.

As bleak as the figures are, delegates here pointed to hopeful developments since the last AIDS conference in Barcelona in 2002. Late last year the premier of China, Wen Jiabao, shook hands with an AIDS patient in a move to bring the disease out of the shadows in that country. Earlier in 2003, President Bush pledged $15 billion over five years for international AIDS assistance.

That single act would have made the president a hero here if he had sent much of the money to the Global Fund for AIDS, Malaria, and Tuberculosis. Instead, most US AIDS money last year went to bilateral programs in 15 African, Caribbean, and Asian countries.

Credit to Congress
Last year Bush proposed just $200 million for the Global Fund, a fraction of Europe's contribution. Congress, to its credit, appropriated $550 million for it, roughly one-third of its total receipts. For 2005, Bush has again called for just $200 million. Congress should at least match last year's total.

The Bush administration has also been criticized for trying to negotiate bilateral trade deals that stop countries from developing generic versions of the next generation of antiretroviral drugs produced by brand-name pharmaceutical companies to replace ones that the virus becomes resistant to. US officials also lose some of the good will that $15 billion should yield by periodically minimizing the importance of condoms -- for example, suggesting that condoms are supportable only for prostitutes or women forced into sex trafficking. Since the United States is by far the biggest single donor of condoms to developing countries -- it will hand out 550 million this year, far more than the highest number under President Clinton -- this is mostly rhetoric to appease Bush's right-wing base, which would like to see the United States supporting just abstinence or, in married couples, fidelity.   Continued...

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