HEALTH U.S. officials defend policy in global fight against AIDS

A fund doesn't allow the purchase of generic drugs.
BANGKOK, Thailand (AP) -- The United States today urged its detractors to end their bickering over condoms and drug patents and join hands with Washington in a global partnership to fight their common enemy: AIDS.
Defending the Bush administration's policy from intense criticism, U.S. AIDS coordinator Randall Tobias said that the United States is spending nearly twice as much to fight global AIDS as the rest of the world's donor governments combined.
"At this point, perhaps the most critical mistake we can make is to allow this pandemic to divide us," Tobias said in a speech to the International AIDS Conference.
"We are striving toward the same goal: a world free of HIV/AIDS. When 8,000 lives are lost to AIDS every day, division is a luxury we cannot afford," he said.
Abstinence
The United States has come under fire this week at the six-day conference over its AIDS policies, with activists, scientists and governments finding fault with nearly every Washington policy on HIV.
Its insistent on abstinence as a first line of defense against HIV has been ridiculed as unworkable by proponents of condoms. Tobias said while the United States is not against condoms, an abstinence campaign in Uganda shows that the contraceptives are not the only solution.
"Abstinence works, being faithful works, condoms work. Each has its place," he said.
"He's lying, people dying," people chanted in near-constant heckling during the speech, which was initially delayed a few minutes when protesters massed near the stage.
President Bush has pledged $15 billion over five years to combat AIDS in Vietnam and 14 countries in Africa and the Caribbean.
"By its actions, the United States has challenged the rest of the world to take action. Please join with us in our deepened commitment to the global fight against HIV/AIDS," he said.
Drugs
Critics say the money comes with strings attached -- it goes to countries that support its abstinence-first policy. Also, the money can buy only brand-name drugs, usually American, shutting out cheaper generic medicines made by developing countries.
A U.N.-launched Global Fund allows generic drugs, costing as little as $150 per person per year, while those approved under the U.S. plan typically cost $700, said Joia Mukherjee, medical director of Partners in Health, which helps treat poor people in Haiti.
"The last thing I want to worry about is which bottle this stuff is coming out of," she told The Associated Press.
She said U.S. administrators in Haiti quietly advise groups to use as much Global Fund money as they can on cheap drugs and, whenever possible, save U.S. money for health workers.
Tobias said Washington insists on name-brand drugs because their quality has been tested by the U.S. Food and Drug Administration, which so far has endorsed only brand-name drugs. However, the agency has indicated it would accelerate any applications for generic drugs.
"America will not have one health standard for her own citizens and a lower standard of 'good enough' for those suffering elsewhere," he said.
An estimated 38 million people are infected with HIV, mostly in poor countries: 25 million in sub-Saharan Africa and 7.2 million in Asia. Only about 7 percent of the 6 million people in poor countries who need antiretroviral treatment are getting it.
Since the last AIDS conference in Barcelona in 2002, the number of people being treated for the disease has doubled in the developing world to 440,000. At the same time, 6 million people died from the virus and 10 million people became infected, WHO figures show.