As AIDS Rages in Asia and Russia, Experts Fear New Funds Are Too Little, Too Late

The UN General Assembly gathers Monday for a one-day special session on AIDS, brightened by the prospect of infusions of money, primarily President Bush's promised $15 billion. Yet among dozens of specialists, the consensus is that the money will not help much unless countries substitute denial with cooperation.

AIDS, they say, must be seen not only as a medical problem but also as a social scourge depleting work forces and disrupting farming. While AIDS drugs can now be supplied at $300 a year per patient, many governments lack the funds or will to provide them, said Richard Feachem, head of the Global Fund to Fight AIDS, TB and Malaria. "If in 1982 when we became aware of the virus we had decided to do nothing in order to observe its course without intervention, the world would be roughly where it is today."

But UNAIDS chief Peter Piot argues that substantial progress has been made. Even so, "We should have invested far more in development, security and political issues," he said. Piot worries that too much focus on drugs will allow governments to neglect AIDS-fighting efforts like counseling, prevention and care.

Many specialists fault turf wars for many of today's problems. While Feachem, a British epidemiologist from the University of California-San Francisco, runs the Global Fund, the worldwide campaign is coordinated elsewhere in Geneva by UNAIDS, a newer version of the Global Program on AIDS pioneered by American virologist Jonathan Mann in the 1980s. Its staff of 250 operates on an annual budget of only $95 million, while the Global Fund now has $4.7 billion to spend in the next five years fighting AIDS, TB and malaria and seeks an annual "cruising speed" budget of $7 billion.

"You've got the money in one agency, and the operational people in another," said Michael Lavollay, a respected French AIDS specialist who was one of Mann's original team at GPA and now works with the UN International Labor Organization.

Kathleen Cravero, Piot's deputy, said the Global Fund had lost time by creating parallel efforts, but she characterized their joint work as effective, if less than perfect. She welcomed the Bush initiative but is uncertain where it will go under the direction of former Eli Lilly chief Randy Tobias, whom she described as "completely new on the scene."

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