International organizations that work with HIV/AIDS issues say unless more money is provided for programs in developing countries, the campaign to eradicate the disease will suffer a 20-year set back.
AIDS activists, some with the HIV virus, protested outside the U.S. Embassy in Johannesburg last month. They say they are afraid that American funding for international AIDS programs might be scaled back.
Activists like Sharon Ekambaram, a spokesperson for Doctors Without Borders, say if the U.S. cuts funding, other countries will do the same. "The AIDS epidemic is still an emergency. It hasn't gone away and it will not go away," she said.
Ekambaram says in countries like Mozambique, 90 percent of AIDS funding comes from international donors.
In Ukraine, HIV/AIDS patients and their supporters protested earlier this month against the possible closure of an HIV ward at a hospital in Kiev. The hospital reportedly has that country's best treatment program for HIV/AIDS.
Doctors and AIDS activists are concerned that people who need treatment will not get it, and the picture of AIDS will once again be that of the dead and dying.
In recent months, in different parts of the world including the United States, there have been reports of doctors turning away AIDS patients from treatment centers because of funding problems. In some African countries, health officials say they can't afford to meet international standards for AIDS treatment.
AIDS expert Anthony Fauci of the U.S. National Institutes of Health addressed the issue at a recent conference. "A very sobering statistic is that for every one person that we put on therapy, two to three people get newly infected," he said.
Dr. Fauci says the number of new infections has stayed relatively the same, under three million a year. But more people are now living with the virus, so treatment needs have multiplied.
Dr. Wafaa El-Sadr from Columbia University in New York says doctors want to reach people with HIV before they become visibly ill, especially pregnant women. They also want to treat babies with HIV. "Obviously, if you need more treatment, you need more money to be able to give people access to the treatment," he said.
U.S. funding for AIDS programs has stayed the same, with only a slight increase of two percent. But Dr. Fauci says he would like to see a greater increase in the budget for these programs. "I think the realistic aspect is that particularly for people who are HIV infected, you cannot right now, with resources that are available, get everyone who needs to be on therapy in the developing world, on therapy. So what we hope for is that there will be other donors," he said.
The AIDS experts say many wealthy countries have not kept their commitment to provide AIDS funding.
And without a vaccine, Dr. Fauci says the best methods of prevention are these:
* encourage people to limit the numbers of sexual partners
* encourage men to use condoms
* train more doctors to perform adult male circumcision
* empower women to choose their sex partners and protect themselves from getting the virus that causes AIDS
All of these goals still remain major challenges.