Bill Gates said that despite growing access to antiretroviral drugs in countries hard-hit by HIV/AIDS, between four and five million people worldwide will become infected in the next year.
"We have to do a much better job of prevention," said Gates, whose foundation just donated $500 million US to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
"We'll never be able to deal with the numbers of people that would have to go on treatment if we don't make a dramatic breakthrough in prevention."
International AIDS conferences are renown for mixing science and politics and Toronto's opening ceremonies were no exception. Conference co-chair Dr. Mark Wainberg drew sustained cheers when he slammed Prime Minister Stephen Harper for slighting the conference, which has drawn 24,000 delegates from around the globe.
"Mr. Harper, you have made a mistake that puts you on the wrong side of history," said Wainberg, director of McGill University's AIDS Centre. "The role of the prime minister includes the responsibility to show leadership on the world stage. Your absence sends a message that you do not regard HIV/AIDS as a critical priority.
"Clearly, all of us here tonight disagree with you."
In Harper's stead, Health Minister Tony Clement told the huge crowd at the Rogers Centre that HIV/AIDS requires "all of us to respond in an unprecedented and historic way."
"That is why we are here this week," Clement said to catcalls of "Where's Stephen Harper?" and protesters holding up signs. One read: "Sleep in, Steve? AIDS never sleeps."
The Microsoft founder said he will call on the world to accelerate research into microbicides — drugs that can block the virus from entering and infecting a person — and oral drugs that would prevent acquisition of HIV. "We hope and expect that this could be the next breakthrough."
Such measures are particularly important because they would benefit women who now have to rely on men to agree to abstinence or condom use "And that simply isn't getting the job done. A woman should never need her partner's permission to save her own life," Gates said.