VIENNA — Some of the world’s top AIDS experts issued a radical manifesto this week at the 18th International AIDS Conference: they declared the War on Drugs a 50-year-old failure and called for it to be abandoned.  Officially, the theme of this biannual AIDS meeting, the world’s largest public health gathering, is the need to attack the rapidly growing epidemic among addicts in eastern Europe, Russia and Asia. It was held in Vienna because this city is the doorway to the East and, in this German-speaking country, all the conference signs are in English and Russian.  (In a lovely ironic touch, the conference hall is only a few steps from the Ferris wheel in the Orson Welles film noir classic set in post-war Vienna, “The Third Man.” On it, a cynical dealer of counterfeit drugs tells his pursuer to look down at the people below and says: “Victims? Don’t be melodramatic.... Would you really feel any pity if one of those dots stopped moving forever?”)  But the organizers’ efforts to get publicity for the Vienna Declaration, which calls for drug users to be spared arrest and offered clean needles, methadone and treatment if they have AIDS, have come to naught. Almost no one here talks about the war on drugs.  Instead, everyone is publicly worrying that the War on AIDS is falling apart. Donor money is evaporating in the recession, and it is looking likely that only about a third of the 33 million infected people in the world will have any hope of treatment.  Frustration is high. Speakers like Bill Gates were interrupted by demonstrators in Sherwood Forest green calling for a “Robin Hood tax” — a tiny fee on the $4 trillion in currency transactions made daily by banks and hedge funds that could raise billions for AIDS.  Many activists blame the Obama administration, which is shifting its priorities to mother-and-child health. The halls are decorated with posters comparing Mr. Obama unfavorably to George W. Bush. On Wednesday, Archbishop Desmond Tutu criticized Mr. Obama in an Op-Ed article in The New York Times.  In his speech here, former President Bill Clinton said Ambassador Eric Goosby, the administration’s global AIDS coordinator, “ought to get some kind of Purple Heart for showing up.”  However, a new report from the Kaiser Family Foundation shows that the United States still gives more than all other countries put together, accounting for 58 percent of contributions. Its donations are still going up slightly, while those from Europe, Canada, Japan and Australia are flat or falling.  Officials from the Global Fund to Fight AIDS, Tuberculosis and Malaria say they fear they will not come close to the $17 billion target they set for their next donors’ meeting in September.  The other, more welcome, distraction has been the exciting results of a South African clinical trial in which a vaginal gel with an antiretroviral drug protected 40 percent of the women using it. This is the first good news about microbicides in decades of work. A gel women can use secretly has long been sought, since many men disdain condoms and many women want to get pregnant.  The Vienna Declaration is only the second time the International AIDS Society has issued such a document. The last was the 2000 Durban Declaration, which reaffirmed that H.I.V. was the cause of AIDS. It was a response to the government of South Africa, the conference’s host, which at the time denied the virus caused disease and refused to buy medicine for its citizens.  Outside of Africa, almost a third of all H.I.V. infections stem from drug injection.  The declaration argues that arresting drug users forces them into hiding, which spreads the epidemic. It backs “science-based public health approaches" proven in clinical trials, which can include everything from clean needle swaps to 12-step recovery programs to methadone.  Dr. Evan Wood, an AIDS policy expert at the University of British Columbia and the chief author, cited Portugal’s approach. According to a 2009 report by the libertarian Cato Institute, in the decade since Portugal legalized possession of up to 10 day’s worth of any drug, including cocaine and heroin, its AIDS rate dropped by half, overdose deaths fell, many citizens sought treatment, drug use among young people fell and drug tourism did not develop. The institute called it “a resounding success.”  The declaration is largely aimed at countries of the former Soviet Union. Russia, for example, is close to having one percent of its adult population infected.  Nonetheless, it forbids all methadone-type treatments, and the national health plan offers only abrupt detoxification, which has a high failure rate. The most frequent victims — prisoners and people not living in their assigned residence areas — are the least likely to get AIDS drugs, and activists say markups vastly inflate the prices of medications bought cheaply by foreign donors.  “The government says everything is fine, we’re even donors to the Global Fund, but we don’t have treatment, we don’t even have prevention,” said Aleksandra Volgina, the 31-year-old leader of Candle, a Russian AIDS organization based in St. Petersburg.
A call at a global AIDS conference to end the war on drugs was lost amid worries over donor money drying up.