Bill Clinton joined Nelson Mandela in calling on America and other countries to spend a lot more money on fighting AIDS, warning that losing the battle against the epidemic would mean "more terror ... more war, destruction."
Issues that dominated the 14th International AIDS Conference included the need to get drugs to more people, the plight of women in HIV-ravaged nations and a honing in on how much the efforts will cost over the next decade.
Experts say that rich nations need to donate $10 billion a year to the effort. Current spending stands at about $2.8 billion. As always, the call for more money to finance work in the developing world was a major focus.
Nobody wrote a fat check. But the German government pledged another $50 million to the Global Fund to fight AIDS, Tuberculosis and Malaria on the last day of the conference.
"AIDS is a war against humanity," said Mandela, who walked onto the stage supported by a cane and warmly embraced Clinton.
Mandela, who had tuberculosis while imprisoned by South Africa's former apartheid government, said AIDS is claiming more victims "than all wars and natural disasters" and cited the United Nations warning that 70 million people could die in the next 20 years "unless drastic action is taken."
He called for access to HIV-fighting drugs "for all those that need it, wherever they may be in the world, regardless of whether they can afford it."
Clinton said "the horrendous march of the pandemic" could mean "more terror, more mercenaries, more war, destruction, and the failure of fragile democracies."
"We cannot lose our war against AIDS and win our battle against poverty, promote stability, advance democracy and increase peace and prosperity," Clinton said.
The former U.S. president praised longtime Sen. Jesse Helms of North Carolina for dropping his opposition to AIDS programs and noted it as an example that anything is possible when it comes to overcoming HIV.
"Do not give up on anyone," he said, holding up a photo of a 4-year-old Nigerian girl who was born healthy because her infected parents took drugs that prevent mother-to-child HIV transmission.
"I will do all I can in the United States and around the world to get more money, more action," he vowed, adding that he and Mandela were launching a World Leaders AIDS Action Network to "raise the global commitment to end AIDS."
Clinton called on Washington to increase its contribution toward the yearly $10 billion goal set by the United Nations.
"We should figure out what our share is and we should pay it," he said, adding that America's share should be increased by nearly $2 billion. He said that would be "less than two months of the Afghan war, less than 3 percent of the requested increase of defense and homeland security budgets."
Seth Berkley, president of the International AIDS Vaccine Initiative, called the Barcelona conference "a splash of cold water" on how the world is doing in the fight against AIDS.
Expectations that there would be widespread access to anti-AIDS drugs in poor countries were shattered by a U.N. report, released the week before the conference, saying only 30,000 people were taking the drugs in sub-Saharan Africa, Berkley said.
In the developing world as a whole, less than 1 percent of people infected with the AIDS virus are receiving drug treatment, according to a recent World Health Organization report.
African doctors said one of the issues not discussed at the conference was that in many cases, HIV patients resell their drugs to villagers to get money for food and that the buyers do not know how to take the medicines properly.
On the science side, favorable results with a new type of drug was good news for patients whose infections have become resistant to all current treatments — offering lifesaving treatment for those who have run out of options.
However, concerns were raised by a report of an American HIV patient who had become infected again with a similar strain of the virus, causing a superinfection -- untouched by all the drugs.
There were also new findings making it even more unlikely that it will ever be possible to eradicate the virus from the body once it has invaded.
There is still no cure and no preventive vaccine on the horizon.
"That makes the case for prevention stronger than ever," said Dr. Ronald Valdiserri, deputy HIV chief at the U.S. Centers for Disease Control and Prevention. "We have to be careful not to let prevention be overshadowed by the significant treatment issues."
"We heard a lot about bringing treatment up to scale, but I frankly was surprised there wasn't more discussion of bringing prevention efforts up to scale."
Especially when experts know what it takes to prevent spread of the virus, Valdiserri said.
"It's not an either-or," Valdiserri said. "That was another point that was made very clear at the conference."
"We need to do both, but particularly given the fact that there is no vaccine or cure around the immediate corner, one of the messages is — let's get behind the strategies that are known to be effective.
"Lets reinvigorate our efforts and approach this epidemic the way we did in the 1980s and 1990s, where we did see a tremendous change in behavior and decreases in transmission," Valdiserri said.
New statistics revealed how the epidemic is evolving globally -- experts predicted increasing numbers of AIDS orphans, a rising proportion of new infections occurring in young people and a shift toward a majority of infections occurring in young women.
"The sense that the epidemic has a woman's face is now everywhere felt and has been repeated time and time again by people at the conference," said Stephen Lewis, the U.N. secretary general's special envoy on HIV and AIDS in Africa.
"In some ways it's the most dramatic breakthrough of the conference and people are talking of a massive campaign to alter, simultaneously on every front ... the entire compendium of terrible social and economic inequality under which women labor and through which the pandemic spreads," he said.
"With 25 million children orphaned, families and communities shredded; with rural parts of societies depopulated and urban centers dealing with millions of street kids ... the questions of what will happen 10, 15 or 20 years from now and what the responsibilities are internationally will undoubtedly be part of the discussion on the road to Bangkok," Lewis said, referrring to the next International AIDS Conference in Thailand in 2004.