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Geneva '98 -- all huff and puff?


 The overwhelming conclusion suggested by the 1998 World AIDS Conference is that the world has not succeeded in controlling the spread of HIV/AIDS and the gap between developing and developed countries is widening. AIDS remains an epidemic of the marginalized and the unequal. This was reflected in the profile of conference attenders. Missing were senior government officials, politicians, and senior representatives of the private sector (including the pharmaceutical industry). New combination therapies have reduced AIDS-related morbidity and mortality, but they are not available in developing countries. Moreover, there are drastic side-effects and the long-term efficacy remains unknown. Antiretrovirals such as zidovudine offer potential to reduce vertical HIV transmission but, even if they were affordable in Africa, their protective benefits would be undone by the economic and social importance of breast feeding. Both governments and the private sector have reneged on their responsibility to invest in AIDS prevention. Continuing social discrimination against people with AIDS and the lack of appropriate community care resources, especially in developing countries, have impeded people's incentive to be tested for HIV. If the World AIDS Conference is to be an effective forum, it must become the place where governments and people with power meet to decide how to put into action the vast store of knowledge that is available about AIDS prevention and control.
