The global commitment to fighting AIDS has increased so significantly that we might at last be turning the corner in the battle against the epidemic, according to one of the world's foremost public health experts. "I genuinely think we may have reached the tipping point," said Dr. William Foege, a former CDC director who is now a senior global health advisor to the Bill and Melinda Gates Foundation. In an interview last week, Foege said that while the number of AIDS cases worldwide will increase for some time to come, the world seems at last to be facing up to the size of the problem.

Last August, President Clinton signed a bill setting up a global trust fund to provide money for AIDS prevention, health care and education to countries hardest hit by the disease. The bill included $300 million for education, testing, counseling, prevention of mother-to-child transmission and care for those living with HIV/AIDS. Over the last 18 months, the Bill and Melinda Gates Foundation has committed about $450 million, including money to search for a vaccine and to support other methods to prevent HIV transmission. Foege said he is encouraged by the growing global commitment to AIDS and by successes in other areas. Uganda, once considered the center of the AIDS epidemic, has reduced rates of infection in almost all areas of the population.

Foege noted that the Gates Foundation is funding research into microbicides that women could use vaginally to protect themselves from infection. "I think if you look at the problem of AIDS in Africa, of all the things that go into making it worse there than other places, not one factor is as important as the lack of power of women," Foege said.

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