Bill Clinton, rock star, AIDS activist, has turned his attention to other matters. He spoke Monday at AIDS2008, where he received a an enormous welcome. Just back from Africa, where he had been checking out his foundation’s global health work, he gave a typically Clintonesque speech—eloquent and impassioned, with the occasional moment of improvisation.

He compared the HIV/AIDS epidemic to a “very big dragon”, one that “must be slain by millions and millions of foot soldiers”. One task for the foot soldiers, and one in which some success has been achieved, is making treatment affordable.

Among the organisations that have helped lower treatment costs is UNITAID. Clinton called their business model, which is based on a tax on airline tickets, “an inspired idea”. He also noted that 1.4 million people are now buying HIV drugs through agreements negotiated by his foundation, agreements that bring the total average yearly cost of treatment to $120 per year. The cost of pediatric drugs has fallen to $60/yr from $600, and the cost of second-line treatment to $670/yr, which he acknowledged is still too high.

President Clinton highlighted some of the challenges that remain: a shortage of health-care workers; a resurgence of infections in the USA, especially among African-Americans; weaknesses in the the overall strength of health systems; the persistence of “AIDS-only” approaches; and continuing gender inequities and violence against women.

He pointed out that there is still a lot of work to do in high-income countries. His declaration coincided with a silent demonstration in front of the podium by advocates for housing for homeless people with AIDS.

As they unfurled banners reading, “Sin casa, con SIDA”, Mr. Clinton said the problems of homelessness and rising poverty resulting from sharp increases in the prices of food, gas, and utilities are urgent problems, especially in the USA. Furthermore, he said, smiling, all those issues were in his speech before the demonstrators showed up. . . .

Faith McLellan