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25 years on, AIDS still spreading

A UN meeting this week takes stock of efforts to fight the disease, focusing on women.

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High-level delegations from around the world gather at the UN in New York this week for a five-year review of global efforts against AIDS that will highlight both progress and worrying trends.

An encouraging note will be sounded by reports that infection rates are falling in some heavily affected African countries, at least in part as a result of modified behavior among African youths.

But with the overall number of HIV cases still increasing - 5 million new ones last year - alarms will be sounded. Chief among them is concern over the growing concentration of the disease among women - with some experts demanding that global prevention and treatment efforts be more seriously focused on them.

"Twenty-five years into this pandemic, it is having a disproportionate impact on girls and women," says Adrienne Germain, president of the International Women's Health Coalition (IWHC) in New York. "We need to change our policies and budgets to reflect" this evolution, "and the UN meeting is a major opportunity to do just that."

Five years after the last major international stocktaking of AIDS - and 25 years after researchers first diagnosed an emerging global health challenge - the world has reached an uneasy consensus on the need for more and better AIDS prevention and treatment programs.

The United States in particular has boosted HIV/AIDS funding, with the Bush administration paying special attention to the impact of AIDS in Africa - and Congress regularly approving higher spending on AIDS than what the administration requests. But that does not mean this week's meeting will be free of the kind of controversy that has marked similar international gatherings in recent years.

For one thing, many development and health groups focused on Africa are critical of US policy. They say it favors a wasteful, unilateral approach instead of joining existing AIDS programs. Beyond that, they argue that US policy harbors an ideological "abstinence only" bent in prevention work that is undermining the widely favored "ABC" approach - abstinence, be faithful, use condoms.

But in particular, some international health and development organizations are demanding a greater linkage of AIDS prevention and treatment campaigns with international reproductive-health efforts. That faces stiff opposition from antiabortion groups, who see the campaign as a backdoor effort to expand abortion rights.

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