by Nigel Marsh - Hope Communications

BARCELONA, FRIDAY - A dead Greek philosopher and two retired Presidents provided the rhetoric and passion to close the Fourteenth International AIDS Conference in Barcelona.

Thucydides was the Greek, recruited by HIV-infected speaker Terry Anderson, for an apt concluding statement:

"Justice will come when those who are not injured are as indignant as those who are."

During a summation of the advocacy positions taken at the conference, Anderson challenged one of the often-repeated activist targets - that three million people in developing nations should be using anti-retrovirals by the year 2005 (a 100-fold increase over the current dismal situation).

"If three million is possible, why not six, why not nine, why not 12 million? Why should not everybody have the right to receive ARVs who need them? Will the people who are not going to receive treatment be part of the consensus that three million is a good target?"

Noting that many HIV-positive people invited to the conference were refused visas by Spanish embassies, Anderson contended that stigma and discrimination still remain a defining characteristic of the AIDS crisis. "This fight is now being fought - and must be fought - on a political basis. We must become more indignant, more angry, more ready to act than we are now."

Former US President Bill Clinton began his speech by estimating how many lives had probably already been saved by the work of scientists, NGOs and anti-AIDS campaigners in the last 20 years, but quickly tempered that optimism.

"You aren't devoting your lives to making the pandemic a little less bad. You are devoting your lives to stopping it, reversing it, and ending it."

After cataloguing a series of broken promises by world leaders to provide funding and leadership, he outlined the strange paradox of HIV: "The world is being consumed by a disease that is preventable, [when we have] drugs that turn a death sentence into a chronic illness, with example after example of nations that have reversed the infection rates. How could we explain that to a visitor from outer space?"

He said the root of the problem lies in a political trend by people who want to live in communities of those who look and think like them - a breeding ground for stigma and discrimination.

"No-one can sit on the sidelines. It's a threat not simply to our health but to our economic well-being and to our very security. 100 million AIDS cases means more terror, more mercenaries, more war, more destruction and the failure of fragile democracies. We can't win the war against terror without winning the war against AIDS.

"Every citizen on our small planet has a personal interest in ending AIDS. There is something for everyone to do. First, the wealthy nations should determine what their share of the $10 billion a year that the UN Secretary General [Kofi Annan] and the experts says is required to spend. We should figure out what our share is, and we should pay it.

"For America, we are spending about $800m this year, so we owe about $2 billion more. That's about two months of the Afghanistan war, or 3% of the increase in budget that has been requested for homeland security.

"For the developing nations it means concluding negotiations with the drug companies in a prompt way, with the option of getting generics from India or Brazil or elsewhere. Developing countries have to work out what they can pay, and send the rest of us the bill for what they can't."

Clinton urged world political leaders to bring an end to official and unofficial stigma and discrimination, quoting as examples recent stories from India where AIDS prevention workers had been subjected to 'unconscionable abuse' by the police.

"In our inter-dependent world we have all suffered sorrows and joy. Our differences are important - they make life more interesting - but our common humanity matters more."

Clinton promised that this year he will visit India and Africa to continue to raise the profile of the anti-AIDS campaign, and that in every speech he makes and meeting he has henceforth he will raise the cause of those who suffer from HIV and the orphans left behind.

"If we can see ourselves in their suffering and find our freedom in their release we will change the course of this pandemic. I know how long you have fought, you many you have buried, and how many tears you have shed. But you know how there are cracks in the glaciers of indifference."

As an example, he quoted Republican Senator Jesse Helms, who said his one regret was not having done more on the HIV/AIDS issues and who asked for $500m expenditure to fight the disease.

And finally Clinton encouraged AIDS campaigners with a Scripture verse, which he claimed had kept him through his 'darkest times' - 'Don't grow weary in doing good, for in due season you will reap a reward if you don't lose heart'.

Nelson Mandela, former president of South Africa and possibly the most widely-respected human alive, noted that six million people had died of AIDS since he addressed the last International Conference in Durban in the year 2000. But the bulk of the passion of his speech was devoted to the tragedy of the 40m African children who have lost one or both parents.

"Nothing is more heart-rending and in need of urgent attention than the cause of AIDS orphans, who are so often rejected by the community. Nothing can shake me more than the sight of these innocent young children suffering physically, socially and emotionally.

"It is projected that there will be nearly 25m more orphans byt 2010," he continued. "This is a tragedy of enormous consequence. AIDS is killing more people than were killed by all the past ward in history, and natural disasters that have occurred. AIDS is a war against humanity."

Continuing with the theme of AIDS orphans, he said: "These children will grow up without the love of their parents, and most will be deprived of their basic rights, shelter, food, health and education. Many will be subject to abuse, violence, exploitation, discrimination, trouble and loss of inheritance.

"We have an obligation to provide the proper care and support for these children. No adult can stand by and watch while these children suffer. As adults we have collective and individual responsibility for them.

"The stigma and discrimination inflicted on these children are atrocious and unconscionable. Many people suffering from AIDS are not killed by the disease itself - they are killed by the stigma surrounding everybody who has HIV/AIDS. That's why real leaders must do everything to help, to fight and to win the struggle aganst this stigma."

He challenged political leaders - and the bi-annual AIDS conferences - with a call to real action: "Eloquence is good but what do you do about it on the ground? Unless we are able to follow what we say by doing something practical to deal with this situation we are less than useless."

Mandela went on to tackle the issue of voluntary counselling and testing - a right for everyone that they should demand - and the provision of anti-retroviral drugs at an affordable price for all. And then he underscored the link between poverty and the spread of AIDS in Africa.

"When you wake up not knowing where you are going to get your next meal, where you can't have decent accommodation for your self and for your children, where you can't feed them, where you can't send them to the bathroom - that is the greatest assault on human dignity. And that's why we should pay particular attention to the poor."

Resorting to rhetoric that would have pleased Thucydides, he asked the leaders of the world if they thought the situation acceptable, when sick parents whose illness could be treated are allowed to die years earlier than would be the case if they had received anti-retrovirals.

"The simple answer is no," he answered himself. "We must find ways and means to make life-saving treatment available to all who need it, regardless of whether they can pay for it, or where they live, or for any other reason why treatment is denied.

"If parents with AIDS could be given a few more years, perhaps seven years or longer, then their children will be given a much better opportunity for nurture, development and survival. Those few years of additonal life will be the most precious of all for both parents and children.

"For those of us who are more fortunate than those parents, it's a timely reminder of the sanctity of human life. We should be prepared to give all that we have got, to give these families that are stricken by AIDS these extra few years."

Mandela gave a special mention to NGOs, which he said were using often meagre resources to make an impact far beyond their size. "One is often moved by the fact that if governments and religious groups had made a similar effort proportionally, we might already have turned the tide of the AIDS pandemic."

And he concluded: "We are all human, and the AIDS pandemic affects us all on earth. If we discount those who are infected with HIV/AIDS we can no longer call ourselves human. The time to act is now. We can make a difference."