WASHINGTON — The U.S. is adding an extra $150 million to the global AIDS fight, taking a first step toward reaching some stigmatized populations.
Despite tough fiscal times, "I am here today to make it absolutely clear the U.S. is committed and will remain committed to achieving an AIDS-free generation," Secretary of State Hillary Rodham Clinton told the International AIDS Conference on Monday.
That's a big goal: Some 34.2 million people worldwide are living with HIV, the virus that causes AIDS, and 2.5 million were infected last year. But the world's largest AIDS meeting this week is debating how to spread scientific advances in ways to stem spread of the virus to get there.
Key is targeting those tools where they can have the greatest effect. "We need to go where the virus is," Clinton told the meeting.
That means a focus on populations at especially high risk: gay and bisexual men, sex workers and injecting drug users. In many countries, stigma and laws that make their activities illegal drive those populations away from AIDS programs that could teach them to reduce their risk of infection, Clinton said.
"If we're going to beat AIDS, we can't afford to avoid sensitive conversations," she said.
Removing stigma is crucial, singer Elton John told the conference.
"We have to replace the shame with love," the British artist said. "We have to replace the stigma with compassion. No one should be left behind."
Included in the new U.S. funding is $15 million for research to identify the best HIV prevention tools to reach those key populations in different countries, and $20 million to create a challenge fund to support country-led efforts to put those findings into practice.
Closer to reality is a goal of virtually eliminating transmission of HIV from infected pregnant women to their babies by 2015, by getting the mothers onto anti-AIDS drugs. HIV-infected births are rare in the United States and are dropping steadily worldwide, although some 330,000 children became infected last year. Clinton said the U.S. has invested more than $1 billion toward that goal in recent years and is providing an extra $80 million to help poor countries finish the job.
Much of the AIDS conference is focused on how to get treatment to all people with HIV, because good treatment saves their lives and reduces their chances of infecting others.
But drugs aren't the only effective protection. Dr. Anthony Fauci of the National Institutes of Health said male circumcision is "stunningly successful" too at protecting men from becoming infected by a heterosexual partner. Clinton said the U.S. will provide $40 million to help South Africa reach its goal of providing voluntary circumcision to half a million boys and men this year.
The world spent $16.8 billion fighting AIDS in poor countries, the hardest-hit, last year, and the United States is the leading donor.
But Bill Gates, the Microsoft founder and philanthropist, said the world is facing great uncertainty about whether wealthy nations will continue funding AIDS programs with the same vigor as in the past.
"As these budget trade-offs are made, the voices of the AIDS community and the global health community are going to have to be louder than ever," said Gates, whose Bill & Melinda Gates Foundation has pledged more than $1 billion to global AIDS efforts.
Another $7 billion a year is needed to get 15 million people in low- and middle-income countries onto medication by 2015, a United Nations goal. A record 8 million received it last year.
"We have to be innovative," said Sheila Tlou, the former health minister of Botswana, now with UNAIDS. "We have to look at new ways of funding."
Speaking to the conference via video, French President Francois Hollande said his country was doing that by beginning what's called a financial transaction tax next month. The tax idea has received a lukewarm reception in other parts of Europe and the U.S.
And researchers from Zimbabwe described how individuals and companies in that country pay 3 percent of taxable income into a National AIDS Trust Fund that has grown large enough to fund anti-AIDS medicines for a quarter of patients using them.
Associated Press writer Joshua Lederman contributed to this report.