The 10 billion dollar question

By Chris Hogg BBC Health Correspondent

The UNAIDS conference may be over but the stickers remain.

Bright orange labels are plastered on the walls, stuck to door and columns, all asking one question.

"Where is the ten billion?".

It has become a rallying cry here among the activists.

This figure is the number of dollars that UNAids, the United Nations Agency leading the fight against the disease, says the world needs to spend every year if this epidemic is to be curbed.

We currently spend just a fifth of that figure on treatment and prevention.

And at the end of a week when that message was endorsed by former President Clinton, hammered home through the global media, there is still no sign of the money.

So was the conference a failure?

The executive director of UNAIDS Dr Peter Piot told me on the first day he wanted to place Aids high on the political agenda.

The coverage this bi-annual jamboree attracts in the media places it briefly on the media's agenda...but it barely lasted the week and this weekend the circus moves on.

World leaders were conspicuous by their absence. A handful from the developing world. The president of Portugal the only head of state from the developed world.

Heckled

Perhaps they were concerned about the reception they would received.

Tommy Thompson the US Health Secretary was shouted down and forced to abandon his keynote speech here in Barcelona by Act Up protestors.

Much anger here was directed at the United States which gives the biggest net contribution to the Global Fund to fight Aids, TB and Malaria.

Critics say the US contributes just a tiny proportion of its national wealth, poorer countries have in comparison been far more generous.

And speaking after his rough reception at the hands of the demonstrators Mr Thompson gave no indication the Bush administration would heed the calls for more money.

Some activists and campaigners here are questioning whether the $14m spent on staging this conference is money well spent.

Much of the scientific evidence published here could be followed just as easy on the web.

No waiting

If a research institution or a biotechnology company discovered a cure for Aids would they wait for the next international conference in Bangkok in 2004 to tell the world? I think not.

What has emerged from the ten thousand scientific abstracts published here has been interesting but hardly ground-breaking.

Yes there was some suggestion that a vaccine might be available sooner than was previously thought but privately many experts here are sceptical about the efficacy of that particular strain.

More interesting has been the work on genomics. The present vaccine strains undergoing clinical trials were all developed prior to the sequencing of the human genome.

That work offers the prospect of more successful products in the future.

New kits to test for HIV and CD4 counts in the field have been developed which will make the process simpler and cheaper - important for those in developing countries trying to improve access to treatment for the worst affected.

And that is important. The problems with getting treatment to those in the worst affected countries appear intractable.

There is an acceptance that the same mistakes must not be made if and when a vaccine is developed.

Finding ways to pay for it, and deliver it must be developed now in preparation for what one leading scientist here described to be as "the Eureka moment".

What is clear though is that this event does provide a focus.

Networking

Those who represent charities say it is a still a good opportunity to network, to meet funders, to share information and experiences with those doing the same in other countries.

That happens despite the way the conference is organised though, rather than because of it. Those planning the next one are likely to look at that issue.

And there was a lot of frustration that many from the developing world were frustrated by bureaucracy which made it impossible for them to get here.

Fortress Europe seemed determined to keep them out, they complained.

Nonetheless the concentration of stories that come out of the conference and were reported on the web, in the papers and on radio and TV, remind people the disease is still an important issue.

But we'll have to hold on a little longer for that 10 billion.