Bush surprised AIDS groups during his Jan. 28 State of the Union address when he proposed the plan, which amounts to a tripling of U.S. spending on AIDS overseas. Officials said it would include condoms and generic drugs as well as faith-based efforts and abstinence education.

Administration officials said funding would not be provided to programs that either promote or perform abortions.

That would be in keeping with the so-called "Mexico City Policy" announced by then President Ronald Reagan at a Mexico City conference in 1984 and rescinded by Bill Clinton when he became president in 1993.

Under U.S. law, no tax dollars have directly paid for abortions since 1973. The Mexico City rule, which was reinstated by Bush, prohibits giving U.S. funds to groups that spend their own money for abortions or counseling.

Critics of the ban call it a "global gag rule" that imposes free-speech restrictions on family planning groups and could lead to even riskier abortions worldwide by denying crucial health counseling.

Administration officials defended the rule and said Bush's AIDS program would provide newfound flexibility.

"As long as none of the money is diverted to family planning activities, they will be able to receive the funding because the president views the AIDS initiative as a health care program that can help people who are suffering," said an administration official.

The White House says the five-year plan would prevent 7 million new AIDS infections and treat at least 2 million people with drugs that can keep an HIV patient alive and healthy.

The program includes the distribution of condoms and instruction on their use, general education and counseling including abstinence education.

In the 25 states that reported new diagnoses of HIV infection, there was an 8 percent increase in the number of cases between 1999 and 2001, Valdiserri told the 10th Annual Conference on Retroviruses and Opportunistic Infections, being held in Boston.

"We see a 14 percent increase in HIV diagnoses over this two-year period in men who have sex with men and a 10 percent increase in heterosexual transmissions," Valdiserri said in a telephone interview. About half the new cases of HIV are in women who are infected by men, the CDC says.

The 25 states represented about 25 percent of HIV cases in the country, Valdiserri said, but did not include New York and California -- the two states with the most cases.

"We are very concerned that it could represent a reversal in the trends that we believe have been relatively stable ... at about 40,000 new cases every year," Valdiserri added.

"We have seen a slight increase in reported AIDS cases for the first time since 1993. It is just a 1 percent increase, but it's the first time since 1993."

Infection with the human immunodeficiency virus used to progress quickly to AIDS -- the breakdown of the body's immune system that leaves a patient vulnerable to infections such as pneumonia and some cancers.

But in the United States and other rich countries, most patients have access to drugs that, while they do not cure HIV, can keep them healthy and symptom-free for years.

'AIDS COMPLACENCY'

While welcoming the drugs, health officials have worried that people often forget how dangerous HIV is. "We are still talking about a deadly disease for which there is no cure," Valdiserri said.

"We are still dealing with this perception that HIV/AIDS is not a problem in America -- is it just a problem overseas," he added. "Some people call it AIDS complacency. I think it is an issue among all people, not just people of high risk. We are still very concerned about the estimated 280,000 people in America who are infected with HIV and don't know it."

An estimated 850,000 to 950,000 people in the United States are infected with HIV and 36 million worldwide.

Valdiserri urged doctors who treat HIV patients to remind them about ways to avoid transmitting it to others -- which include safer sex and letting sexual partners know they are infected.

He said the CDC had investigated a number of outbreaks of syphilis among gay and bisexual men that showed between 43 percent and 59 percent of those turning up with syphilis -- which, like HIV, is transmitted by oral, anal and vaginal sex -- knew they were HIV positive.

That suggests the men were having unprotected sex despite knowing they could pass on the virus.

"HIV-infected people need support so they don't transmit the infection to others," Valdiserri said. Busy doctors may have only a few minutes, but nurses and other staffers in clinics can help, he said.

"Most governments have already accepted this (proposal), but we have to wait to see how the U.S. government will respond," Perez Motta said.

It was the refusal of the United States — under pressure from U.S. pharmaceutical manufacturers — to fall in line with the WTO's other 143 members that caused talks to collapse before Christmas, the deadline the WTO had given itself to solve the problem.

Trade ministers meeting in Qatar in November 2001 recognized the right of WTO members to override patents on expensive Western drugs and make the products themselves when public health is at stake.

However, drugs made under such "compulsory licensing" were to be used only domestically and not exported. As most developing countries have no drug industry, they cannot benefit because they can neither make the drugs they need nor import them.

A proposed agreement that would allow imports in certain situations was rejected by Washington, which claimed that some countries could use the rules to ignore patents on drugs to treat noninfectious illnesses like asthma, diabetes or obesity. That could remove the incentive for drug companies to develop new treatments, it said.

The U.S. proposal to produce a list of diseases covered by the agreement was rejected by developing countries, who insist it is up to them to decide what constitutes a public health crisis.

Perez Motta has proposed that members should accept the text of the agreement put forward before Christmas, but now it would be accompanied by a clarifying statement by the chairman of the WTO's ruling General Council. That would say that governments understand that the measure should be used for "national emergencies or other circumstances of extreme urgency."

There was no immediate reaction from the U.S. government, but Perez Motta told reporters he believes U.S. drug companies are beginning to come round.

"We think it could make the difference and could perhaps get enough confidence on both sides — especially the pharmaceutical industry — to come alone with all the rest of the WTO constituency," he said. "The U.S. government didn't say no at the outset, they said it looks interesting and they have to consult."

He added that no delegation thinks the text is perfect, but most are prepared to accept it. He said it was a "take it or leave it draft" because a change that suits one country would be unacceptable to another.

Although not formally on the agenda, the issue likely will be discussed at length during a three-day meeting of trade and agriculture ministers from 25 leading WTO members opening Friday in Tokyo.

The meeting is supposed to add momentum to a wide round of negotiations aimed at opening markets to international trade, and comes a few weeks before the WTO faces deadlines to agree how to proceed in several areas including the tricky issue of agriculture on which countries are bitterly divided.

By Deborah Mitchell

BOSTON (Reuters Health) - One of the biggest problems in fighting AIDS is guaranteeing that money earmarked for the cause will get to the people who need it the most, former US president Bill Clinton told attendees here Monday at the 10th Conference on Retroviruses and Opportunistic Infections.

To help that happen, Clinton said his William J. Clinton Foundation, in collaboration with the Harvard AIDS Institute, Columbia University Medical School and other organizations, is striving to help countries develop better systems to deliver care. The former president, along with Nelson Mandela, is also co-chairman of the International AIDS Trust.

The groups are trying to fill "one of the single biggest gaps" in the delivery of HIV/AIDS services, which is "the absence of systems in the countries with high and growing AIDS rates," Clinton said.

In 1998, as he began to visit African countries most affected by HIV, Clinton observed a "breathtaking difference" among countries' ability to use their resources to treat the maximum number of patients.

For example, some countries, such as Uganda, Senegal and Brazil, have had much greater success than other countries with similar amounts of money.

"I think, by and large, there are systematic reasons" that explain this, he said. So the mission of his organization is "to try to come up with comprehensive strategies that would enable every country that has a willing political leadership to get the same results as the countries that have turned the epidemic around."

To this end, his foundation has signed a memorandum of understanding with 15 Caribbean countries and three African countries.

To illustrate how this can work, Clinton cited the example of the Bahamas, where the government was spending $3,600 per person per year on generic medicines.

"Within a week, we had their price cut down to under $500 a year--so they now can serve seven people for the price they were serving one person," he said.

Clinton commended the new increase in AIDS funding proposed by President Bush in his state-of-the-union address. While Clinton still believes that more US funding should go to the Global AIDS Fund, he noted that it was important "not to rush to judgment" and to wait and see how effectively the new funds will be used.

What is critical now, he stressed, is to make sure the Bush initiative makes it through the US Congress.

We need to "keep it high on the radar screen," he said.

He also pointed out the importance of not losing the gains that have been made by taking away from existing programs in the US. For example, 40% of HIV-infected individuals in the US receive care from Medicaid, he said, and cuts by Congress could have a devastating effect on these programs.

Also groups with high or increasing rates of HIV, such as young gay men, intravenous drug users and African Americans--especially young women--still require particular attention in the areas of prevention and treatment, he said.

By Philip Blenkinsop

BERLIN (Reuters) - A controversial film about gay men who deliberately contract the "gift" of the HIV virus or recklessly risk doing so debuted at the Berlin Film Festival on Tuesday.

Louise Hogarth's "The Gift," finished just a few days ago, is a collection of interviews with gay men, mostly from the west coast of the United States, looking at the AIDS crisis two decades after it struck.

The documentary's debut follows an article in "Rolling Stone" magazine last month quoting a San Francisco physician as estimating that at least 25 percent of gay men newly infected with the HIV virus had deliberately sought it out.

The article caused sensational headlines worldwide, one newspaper saying "Gays want AIDS," and upset many AIDS charities who have said that suggesting gays are responsible is both wrong and a threat to their funding.

Louise Hogarth's film looks at the phenomenon of "Bug Chasing" -- deliberately contracting the HIV virus -- and "Gift Giving" -- passing it on to others -- although she does not claim that either practice is rife.

Nevertheless, her interviews feature a number of men who have deliberately sought out the virus and some who continue to have unsafe sex despite being HIV positive.

"I was relieved. I didn't have to worry. Do I need to be careful -- not any more," said "Ken," recounting the time he found out he had contracted the virus.

Doug Hitzel, a 21-year-old from San Francisco, also chose to become infected with HIV, although he now regrets his decision.

Some interviewees describe a feeling of guilt many without the virus can feel, a sense of not belonging to a brotherhood of the infected. Others describe an apparent rise of unsafe sex among gay men and an increase in parties advertising it.

"It is a growing phenomenon. I just looked at my own zip code and found there were three such parties in my area...and they are all over, in Berlin too," Hogarth said.

Without moralizing, the film offers an insight into a besieged community trying to come to terms with the AIDS pandemic and of an apparent unwillingness of some to discuss the issue after years of seeing loved ones and friends die.

This may have led to a dearth of sufficient information beyond the simple "safe sex" message, such as that two HIV positive people can still damage each other's health through unsafe sex.

Hogarth, who said she had often thought of ending her project and had received little backing from gay organizations, said she hoped her film would stimulate renewed discussion, particularly about prevention, without harming fund-raising.

"I've made a terrible mistake and there's no fixing that. There is no benefit in this and that's what needs to be said," says Hitzel, the central focus of the documentary.

By CURT ANDERSON, Associated Press Writer

WASHINGTON - The worldwide AIDS epidemic undermines the stability and economies of many countries, creating chronic problems that may threaten U.S. national security, CIA Director George J. Tenet said Tuesday.

More than 40 million people are infected with the virus that causes AIDS, most of them in southern Africa, Tenet told the Senate Intelligence Committee. About 3 million people died last year of the disease.

A recent intelligence report estimates that there may be 100 million AIDS cases outside Africa by 2010. Tenet said India alone could have up to 25 million cases — more than any country in the world — with up to 15 million cases projected in China.

"The national security dimensions of the virus is plain: it can undermine economic growth, exacerbate social tensions, diminish military preparedness, create huge social welfare costs and further weaken already beleaguered states," Tenet said. "And the virus respects no border."

President George W. Bush has asked Congress for $15 billion over the next five years to battle AIDS around the world, up from $5 billion already planned in 14 African and Caribbean countries. Bush is also asking for $16 billion to fight AIDS in the United States, an increase of 7 percent.

The National Intelligence Council report on the global AIDS threat, released late last year, also predicted that a significant increase in AIDS cases would occur in the next decade in Russia, Nigeria and Ethiopia.

Sharing of infected drug needles is the main cause of the disease's spread in Russia, where the estimated 2 million HIV-positive cases today is expected to grow as high as 8 million by 2010. Nigeria's cases could rise from about 6 million to as many as 15 million — about a quarter of the adult population — and Ethiopia could have up to 10 million cases, up from between 3 million and 5 million.

GRAHAMSTOWN, South Africa - U.S. Ambassador Cameron Hume criticized South Africa's fight against AIDS, questioning if it will use the U.S. money it is being given to fight the pandemic.

Hume was referring to U.S. President George W. Bush's recent pledge to give US$15 billion for AIDS relief. Hume said Tuesday that money to fight AIDS in South Africa would not help if the government failed to make good use of the money, the South African Press Association reported.

An estimated 4.7 million South Africans, 11 percent of the population, are infected with HIV.

Critics say the government has been sluggish in confronting the pandemic, but officials say the country must rally behind the government's new AIDS strategy, which includes awareness campaigns, treatment of related infections and research.

By DANIEL Q. HANEY, AP Medical Editor

BOSTON - A variety of highly effective new AIDS drugs are on the horizon, experts say, easing worries that the fast-mutating virus will outstrip doctors' ability to treat it.

Ever since combinations of AIDS medicines transformed HIV into a manageable condition in the mid-1990s, doctors have worried that the virus would eventually mutate into forms that would elude their control. While HIV indeed has evolved into many drug-resistant forms, most patients are still able to find combinations that hold their virus in check.

At the 10th Conference on Retroviruses in Boston, experts said the outlook for potent and novel medicines to control HIV has never been brighter.

"The pipeline of new drugs has an impressive number of candidates in it. This is something we haven't seen in past years. It's a bumper crop," said Dr. John Mellors of the University of Pittsburgh.

Currently, 16 drugs are approved by the Food and Drug Administration to fight AIDS. Most of the medicines are aimed at just two targets in the virus's life cycle, proteins called protease and reverse transcriptate.

However now, doctors say, drugs are in development that are aimed at eight different points in the process by which HIV attaches itself to blood cells, enters them and finally makes new copies of the virus.

The next new drug expected to win FDA approval is T-20, being developed by Roche and Trimeris Inc., a so-called fusion inhibitor that blocks HIV from sticking to the blood cells that it attacks.

At the meeting Tuesday, doctors described encouraging results with the next generation of this drug, called T-1249, that is intended to be used when the virus grows resistant to T-20. Dr. Diego Miralles of Duke University said that even more versions are in the design stage to take over when T-1249 fails.

"I am very encouraged this year that we seem to be keeping up with the virus in terms of our ability to treat resistant virus with new drugs," Mellors said.

At least a half dozen promising drugs are in human testing, he said, and 10 or 12 more are in the pipeline.

Furthermore, AIDS medicines have gotten much easier to take. Just a few years ago, patients had to take 20 or so pills on a carefully timed daily schedule. Now that total is down to just two or three pills taken once or twice a day.

Among the new drugs in testing is one TNX-355, an antibody from Tanox Inc. Unlike other drugs, this one works by blocking the spot on blood cells where HIV normally attaches itself. Initial testing by Dr. Daniel Kuritzkes and others from Brigham and Women's Hospital in Boston found an injection once every one to three weeks dramatically reduced virus levels.

LUANDA, Angola - Angola has at least 1 million HIV-positive cases and the deadly virus could quickly spread unless preventive measures are improved, Health Minister Albertina Hamukwaya said Wednesday.

Hamukwaya told a news conference the estimated number of HIV-positive cases was based on a government survey in just four of Angola's 18 provinces. The national total likely was much higher, she said.

Hamukwaya held talks with the top U.N. official for AIDS in Africa, Michel Sidibe, who warned the number of cases was "severe" because the health service was devastated in the country's two-decade civil war which ended last year.

"All the ingredients are there for an explosive increase" in the number of cases, said Sidibe, director of the Africa Division of UNAIDS.

Angola's population is estimated at about 13 million.

Poor education levels, inadequate health services and the 4 million displaced people gathered mostly in overcrowded cities made Angola vulnerable to further rises in the number of HIV-positive people, according to Sidibe.

The United Nations views Angola as a high-risk country for the spread of AIDS.

About 28 million of the 40 million people infected with AIDS worldwide live in sub-Saharan Africa, including Angola, according to a recent U.N. report.

To: National Desk

Contact: Adam Coyne/EGPAF, 310-314-1459, 310-497-4497 (cell)

BOSTON, Feb. 12 /U.S. Newswire/ -- At a special ceremony held in conjunction with the 12th Conference for Retroviruses and Opportunistic Infections today, the Elizabeth Glaser Pediatric AIDS Foundation announced more than $3 million in new grants for its HIV/AIDS research programs. The Foundation presented two of the most promising HIV/AIDS scientists -- Dr. Paul Bieniasz and Dr. Grace John-Stewart -- with its highest award, the Elizabeth Glaser Scientist Award. The Award provides $700,000 for five years of research dedicated to the treatment and prevention of pediatric HIV/AIDS. The Foundation also announced new funding to support eight Basic Research Grants and three Scholar Awards, including studies focused on preventing mother-to-child transmission, a unique project aimed at preventing breastmilk transmission, and a novel drug discovery project, among others.

"A rare combination of compassion and collaboration drives the new Foundation-funded researchers and their efforts to find more effective treatments to slow HIV in infected children, demonstrate strategies to prevent infection in newborns around the world, and ultimately develop a preventative vaccine," said Kate Carr, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation. "The Foundation's unique research programs invest in the scientific leaders of today and tomorrow. We fund innovative projects that are not supported elsewhere, bring vigorous minds together, and serve as a voice for children."

Elizabeth Glaser Scientist Awards Drs. Bienasz and John-Stewart join the 30 Elizabeth Glaser Scientists who are working together to help ensure that the world's next generation of children is born free of HIV/AIDS and that children living with HIV/AIDS will grow to enjoy a healthy adulthood.

Dr. Paul Bieniasz is a staff investigator at the Aaron Diamond AIDS Research Center and an associate professor at The Rockefeller University in New York. He is addressing the ongoing need for new antiretroviral compounds and vaccine candidates that can be used to curtail the pediatric AIDS epidemic. Dr. Bieniasz's study will examine the role of cellular inhibitors in protecting cells from infection by HIV and related viruses.

Dr. Grace John-Stewart is an associate professor at the University of Washington in Seattle. Through her Elizabeth Glaser Scientist Award she will evaluate viral and immune responses to antiretroviral regimens in breastfeeding HIV positive mothers and their infants to increase our understanding of how these regimens may decrease breastmilk transmission of HIV.

Scientists currently funded by the Elizabeth Glaser Scientist Award have achieved significant advances in pediatric HIV/AIDS research. These advances include demonstrating the benefits of administering aggressive triple combination anti-HIV drug therapies to infants, developing additional interventions to prevent mother-to-child transmission that are easier to implement in developing countries, and studies that could lead to immune system regeneration and the development of a vaccine.

Basic Research Grants The Foundation's one- and two-year Basic Research Grants provide funding for up to $200,000 for novel and innovative research, often in its preliminary stages. The investment offers scientists the potential for breakthroughs in previously unexplored areas of research. The eight new Basic Research Grant recipients include:

-- Chandice Covington, Ph.D., University of California at Los Angeles. "Feasibility of Surrogate Breastmilk Replacement Feeding to Prevent Mother-to-Child HIV Transmission in Sub-Saharan Africa"

-- Keith Fowke, Ph.D., University of Manitoba. "Epidemiological and Functional Assessment of a CD4 Polymorphism in Perinatal HIV Transmission"

-- William Moss, M.D., Bloomberg School of Public Health, John Hopkins University. "Measles and Measles Immunization in HIV-Infected Children"

-- Paul Palumbo, M.D., UMDNJ-New Jersey Medical School. "Mapping Viral Epitopes for Evidence of Immune Escape"

-- Hugo Soudeyns, Ph.D., University de Montreal. "HCV-Specific Immunity During Pregnancy: Modulation by HIV Co-infection and Antiretroviral Therapy"

-- Sten Vermund, M.D., Ph.D., University of Alabama at Birmingham. "Anthelmintic Therapy to Slow HIV Progression in Children"

-- Dean Kedes, M.D., Ph.D., University of Virginia. "A Novel Animal Model for Kaposi's Sarcoma Pathogenesis"

-- Paul Spearman, M.D., Vanderbilt University School of Medicine. "Pseudovirion Formation by Live Vector HIV Vaccines"

Scholar Awards The Scholar Award is an incentive and mentoring program that allows a new generation of scientists to explore an early professional interest in studying pediatric HIV/AIDS. Scientists are given salary support of up to $96,000 for two years of work with a sponsor who has an established track record in the field. Through the mentoring relationship, young scientists focus their efforts on helping to bring an end to HIV/AIDS in children. The new Scholar Award recipients are:

-- Geraldine Gillespie, Ph.D. MRC Human Immunology Unit, Oxford, UK. "Characterization of Cross-Reactive CD8(plus) T Cell Immunity in HIV-1 Infection and in HIV-1 Vaccine Recipients"

-- Deepika Mohan, Ph.D., Seattle Biomedical Research Institute. "Perinatal Transmission of SHIV 162P"

-- Renate Koenig, Ph.D., The Salk Institute. "CCR5 Antagonists: Mechanism and Resistance"

About the Elizabeth Glaser Pediatric AIDS Foundation: The Elizabeth Glaser Pediatric AIDS Foundation is the leading worldwide non-governmental organization dedicated to identifying, funding, and conducting pediatric HIV/AIDS research as well as promoting global education, awareness, and compassion about HIV/AIDS in children. Through its international Call to Action Project, the Foundation is leading the way in successfully preventing mother-to-child transmission of HIV in the developing world and laying a foundation for additional care and support for families with HIV. Building upon the successful model it created with HIV/AIDS, the Foundation is also addressing other serious and life-threatening diseases facing children through the Glaser Pediatric Research Network. The Network brings together five of the nation's pre-eminent academic medical centers in an unprecedented collaboration that will accelerate better treatments for seriously ill children, help train the next generation of pediatric clinical investigators, and serve as a united voice to advocate policies that improve children's health worldwide.

CAPE TOWN (Reuters) - A ex-convict, who sued South Africa's prison authorities after catching HIV, has clinched a landmark pay out -- the first time the government has been held accountable for the spread of HIV in overpopulated prisons, officials said on Wednesday.

AIDS activists cautioned that, because the out of court deal was confidential, it would not necessarily set a legal precedent which could open the door to more such lawsuits.

South Africa has the world's highest number of people with HIV, the virus that causes AIDS. One in five South Africans, more than 4.5 million, live with the disease, and the epidemic is believed to be spreading even faster in the prison system.

In his 1.1 million rand ($132,500) lawsuit, the former inmate said he contracted HIV from a fellow inmate while in prison from 1993 to 1994 -- when prison authorities did not warn inmates about the dangers of unprotected sex or supply condoms.

"A material portion of prisoners were HIV-positive at the time. It is inevitable that prisoners who engaged in sex would have been infected with the HIV virus," the plaintiff said in court papers, adding that officials were aware of sex between prisoners.

He said he would not have had sex and, subsequently, contracted the virus had he known of the risk.

Under the terms of the deal, the Department of Correctional Services denied any liability but admitted prisoners were not allowed to have condoms until 1996 when policy changed.

Department spokesman Luzuko Jacobs confirmed that the government had made a financial offer to settle the case, but declined to give further details.

In an earlier draft settlement, the parties had agreed to compensation of no less than 100,000 rand ($12,048) plus medical and legal costs, without an admission of liability.

BASEL, Switzerland - Swiss pharmaceuticals giant Roche said Thursday it will slash the price of its AIDS drug Viracept for sub-Saharan Africa and poor countries elsewhere.

The company said it was offering "no profit" prices for delivery direct from its Swiss factory, starting March 1.

The offer brings the price of Viracept down to about US$900 per year, only 15 percent of what the company charges in Switzerland. Roche also cut prices of Invirase, another protease inhibitor — a drug that cripples an enzyme the HIV virus needs to reproduce.

"Our revised policy demonstrates Roche's commitment to the fight against HIV and to further accelerate access to care in these African and least-developed countries," said William M. Burns, head of Roche Pharma, the Swiss manufacturing arm of the company.

"The no profit prices direct from Roche Basel are the lowest prices at which the products can be provided in a sustainable manner," the company added. "They do not reflect research or development costs, marketing costs, distribution costs or company overheads."

Nobel Peace Prize-winning aid group Medecins Sans Frontieres welcomed the announcement and said it had been putting pressure on Roche for some time.

Though Roche has joined a pharmaceutical companies initiative to reduce prices of AIDS drugs in poor countries, until now the reduction has only been around 40 percent while other companies were offering cuts of up to 92 percent, MSF said. In some countries, such as Guatemala and Ukraine, the cost of Viracept was higher than in rich Switzerland.

The 85 percent reduction puts Roche in line with offers made by other pharmaceutical companies.

MSF, known in English as Doctors Without Borders, said it had taken a long time to persuade Roche to act.

"The long struggle to reduce the price of this Roche drug is proof of the limitations of a fully voluntary system. For new drugs there needs to be an internationally supported enforceable system that reduces prices to affordable levels in developing countries."

Around 40 million people around the world are infected with the HIV virus, and 28 million of those live in sub-Saharan Africa, according to the United Nations

BANGKOK (Reuters) - Thailand signed a deal on Thursday to sell cheap generic antiretroviral drugs to Indonesia and promised to start exporting to China and South Africa, in a move likely to rile global pharmaceutical giants.

Members of the World Trade Organization (WTO) agreed at the 2001 Doha summit that countries would be allowed to produce their own generic antiretroviral drugs in case of a national emergency even if they were patented by private firms.

The deal angered many global pharmaceutical giants, who feared they would not recoup high research and development costs if there were free global trade in generic drugs.

The US blocked WTO moves in December to formally allow countries without production facilities to import generic drugs in contravention of patents, although WTO members have agreed not to take legal action while the issue is sorted out.

Thailand, where several international pharmaceutical firms do not register their antiretroviral drug patents, said on Thursday it hoped the deal with Indonesia would herald a flow of exports of cheap generic drugs to other countries.

"We are trying to tap large markets like China and South Africa, but those countries have patents of drugs we want to sell," Public Health Minister Sudarat Keyuraphan told reporters.

"So we are working with those countries to seek some leeway to be able to sell our drugs there. The more markets Thailand can find for our drugs, the cheaper the costs of production, and this will benefit Thai consumers."

The head of Thailand's Government Pharmaceutical Organization, Thongchai Thavichachart, told Reuters that Indonesia had come to "an arrangement" to bypass patents which covered drugs imported from Thailand. He gave no further details.

Indonesian Health Minister Achmad Sujudi signed the $1.95 million deal, which will see Jakarta buying six types of Thai-made antiretroviral drugs over the next three years.

The drugs will be distributed at Indonesian state hospitals to 80,000 to 120,000 people living with HIV/AIDS.

By Toby Reynolds

JOHANNESBURG (Reuters) - Years of aid work have done little to contain HIV/AIDS in southern Africa, and those working to stave off a regional food crisis need to change their tactics to take account of the killer disease, a UN report said.

Food shortages affecting more than 14 million people owe much to the predations of AIDS, which has particularly hit breadwinners, United Nations regional special envoys for humanitarian needs, James Morris, and for HIV/AIDS, Stephen Lewis, said in the report, released late on Thursday.

The report said those combating the disease should promote the rights of overworked women, act to ensure AIDS orphans' needs were met and intervene to stop the collapse of whole sections of skilled society.

"The last decade or more of internationally supported development planning has had little or no impact in containing the spread of HIV/AIDS... The mission recommends a complete revision of the current approach of the United Nations to the provision of assistance," the report said.

The UN said on Friday that an appeal it launched in July 2002 had raised only $350 million of $611 million requested for a year's worth of food, medicine and agricultural supplies.

ONE DEATH EVERY 10 SECONDS

Thursday's report restated the view that HIV/AIDS was the root cause underlying southern Africa's food crisis. It urged governments and non-governmental organizations (NGOs) to see the link between food security and AIDS, which claims one person worldwide every 10 seconds.

"HIV/AIDS is both a cause and a consequence of the food shortage: households that have lost breadwinners and caregivers to AIDS are poorer and more vulnerable to starvation.

"In turn, those who are hungry are more vulnerable to HIV infection and to the rapid progression of the virus into full-blown AIDS."

The report urged action to lessen the impact of AIDS on women, key guarantors of food security in Africa. It said women bore the brunt of caring for people with HIV/AIDS, and called on governments to legislate to even out gender inequality.

It said the apparent inability of the UN and the international community to help governments tackle the huge number of orphans in the region was unacceptable. Measures to give each child an adult supervisor should be implemented immediately.

The report also sniped at the regime of Zimbabwean President Robert Mugabe, who has been vilified by many commentators for exacerbating his country's worst economic crisis in decades.

"It is clear that weak, insufficient or inappropriate policies in several countries of the region, particularly Zimbabwe, are hampering both the ability of humanitarian assistance to be delivered and any serious consideration of long term strategies," the report said.

By DANIEL Q. HANEY, AP Medical Editor

BOSTON - Seven years into the modern era of AIDS treatment, the outlook for people with HIV infections continues to improve.

Encouraging new European data released Friday show that the risk of developing full-blown AIDS or dying of the disease is still falling.

In 1996, treatments became widely available that abruptly changed the prospects for people with HIV. These people once faced almost certain death, but the combinations of drugs have made HIV a treatable and largely survivable infection.

Still, many have wondered how long these benefits would last. Currently, 16 AIDS drugs are on the market, and many more are in development. Yet some patients have resistant forms of the virus that flourish despite shifting combinations of pills. Others have worrisome side effects, such as rising cholesterol levels.

However, figures presented Friday at the 10th Conference on Retroviruses show that despite all the drawbacks, the drugs continue to work well, and their benefits have not been exhausted.

Dr. Amanda Mocroft of Royal Free and University College Medical School in London outlined the outcomes of 9,803 people diagnosed with HIV in Europe between 1994 and 2002. Between 1994 and 1998, their risk of AIDS or death fell by 80 percent.

Since then, improvements have continued. Between September 1998 and 2002, the risk of AIDS or death has fallen 8 percent each six months.

"Even though therapy is not perfect, it's working," Mocroft said.

The continuing decline in death and AIDS is a surprise, she said. "An awful lot of people expected the curve to bottom out or even rise again, but it's still going down," she said, "which is very encouraging."

The outlook is worst when people have high levels of virus and few of the blood cells that HIV attacks. Mocroft's team found that survival has significantly improved in recent years among people who start treatment with low blood counts but not among those with higher levels.

"It's quite remarkable. You have to wonder what the end of the story will be," said Dr. Kevin DeCock, head of the U.S. Centers for Disease Control and Prevention's program in Kenya.

In the United States, the CDC has followed 1,769 Americans diagnosed with HIV since 1994, and "we have data that corroborates what the Europeans are saying," said Dr. Scott Holmberg, a senior epidemiologist.

The first goal of treatment is to drive down the virus so it falls below the ability of detection on standard tests, which can find 25 copies of HIV in a milliliter of blood. In the mid-1990s, many worried that virus levels would begin to rise again as resistant forms of HIV evolved, but Holmberg said the opposite has happened.

"We are seeing more people who are able to suppress to undetectable viral loads," he said. "HAART continues to do better and better."

HAART — highly active anti-retroviral therapy — is what doctors call the combinations of pills that have revolutionized the treatment of AIDS.

Holmberg said that while deaths from all causes among people with HIV have stabilized in the United States in recent times, deaths from AIDS itself have continued to fall. Instead, they are dying from heart disease, liver problems, cancer and other ills unrelated to their HIV infections.

Another analysis from Dr. Jonathan Sterne of the University of Bristol in England found that how people do in their first six months of treatment is more important in the long run than their initial blood counts and virus levels.

"It matters where you are, not where you came from," he said.

Those who have respond the best after six months have only a 2 percent risk of death over the next three years, compared with an 83 percent risk among those doing the worst after six months.