AIDS: the world's future is in 'their' hands, but comes from 'our' pockets; an impression from the World AIDS Conference in South Africa

The HIV-Aids epidemic is a global disaster with vast social, economic, psychological and medical implications. With 34 million persons infected and 19 million cumulative deaths since the start of the epidemic, its impact surpasses all other diseases. The end of the epidemic is not in sight and we will see an increase of HIV cases during the next decennia before the epidemic levels off. This warrants a global solution. Small, nongovernmental projects can never curb this epidemic. The world has to establish a 'global fund', which allocates the resources on a nationwide scale. We should think in billions of dollars and not millions. Political commitment and a nationwide approach are the keys to success. Stigma is still the most important issue that hinders prevention. Offering care to the people will make it worthwhile for them to be tested. Anti-retroviral treatment is, with current price settings, unaffordable for patients in developing countries. Selective use of these expensive drugs could, however, play a part to put Aids on a national agenda. Prices of anti-retroviral drugs will have to come down. The current situation with the North having all the drugs but relatively few patients, and the South many patients and no drugs, is ethically unacceptable.