Nelson Mandela calls for unity at the XIIIth International AIDS Conference in Durban, South Africa.

for unity at the XIIIth International AIDS Conference in Durban, South Africa Former South African President Nelson Mandela closed the XIIIth International AIDS Conference in Durban with a call for unity in the fight against the HIV/ AIDS epidemic. He commented: ‘‘We will have to rise above our differences and combine our efforts to save our people. History will judge us harshly if we fail to do so now’’. The speech did much to dispel the disappointment surrounding the opening remarks of current President Thabo Mbeki, who did little to remove the perception that he still has doubts about the cause of the epidemic. Mbeki angered some in his opening remarks by failing to take the opportunity to state clearly that HIV is the cause of AIDS. Mr Mandela’s speech served to focus attention on one of the main issues of the conference — 90% of those infected with the virus live in developing countries, many in sub-Saharan Africa, and are unable to afford treatments for the disease. Other matters discussed included the effect of violence on the progress of the epidemic. Speaking at the meeting, Dr Gro Harlem Brundtland, Director-General of WHO, commented: ‘‘Violence against women is an important contributor to HIV’s spread...We will not achieve progress against HIV until women gain control of their sexuality’’. Studies in the Republic of Kenya and the United States have shown that up to one-fifth of women with HIV reported having experienced violence as a result of their HIV status. People must speak out against all forms of violence against women, including rape, domestic violence, and sexual abuse. ‘‘Women must know and feel that society supports them when they say no to unwanted or unprotected sex,’’ Dr Brundtland added. In studies of new ways to prevent HIV transmission, disappointing results were presented for the use of the spermicide nonoxinol-9. The spermicide, used in gel form, was hoped to be an effective means of protecting women from HIV infection, but results from a phase III clinical trial showed this not to be the case. A microbicide would be a major breakthrough in preventing the spread of AIDS since women could protect themselves from infection without the need to secure the cooperation of their partner. Much of the research reported at the conference focused on addressing problems in developing countries. James McIntyre and Glenda Grey of the University of the Witwatersrand, South Africa, reported that nevirapine could drastically reduce the transmission of the virus from infected mothers to their newborn infants. The incidence ofHIV in newborns was drastically reduced after administration of two doses of the drug, one during labour to the mother and the second 24–48 hours after birth to the baby. Before the meeting, Boehringer Ingelheim announced that nevirapine will be distributed free of charge to developing countries for five years in an attempt to reduce vertical transmission of HIV. Activists and others emphasized that pharmaceutical companies and governments should think hard about ensuring effective ways for such drugs to reach those who need them most. n Barry Whyte, Bulletin News