Great strides have been made in fighting the spread of HIV/AIDS and increasing access to treatment, but delegates gathered in Kampala this week for an international conference on the illness know that stiff challenges lie ahead...

The HIV/AIDS Implementers Meeting, organized by United Nation's agencies and the US President's AIDS Fund, has focused on how to overcome the hurdles that stand in the way of rolling back the spread of the disease.

UNAIDS Deputy Executive Director Michel Sidibe said that deaths from the illness were actually going down due to increased access to drugs, increased funding and aggressive awareness programs.

'There has been a downward trend for the past six years,' Sidibe told Deutsche Presse-Agentur dpa on the sidelines of the conference. 'People are living longer and treatment is becoming available to more people.'

According to Sidbie, some 2.2 million people - 1.7 million of them from Africa - were dying each year compared to an earlier figure of 2.9 million - 2.2 million of them in Africa.

'We have increased the number of people on treatment during the past six years where we saw broader programs, more resources committed to the epidemic and prices going down for the drugs,' Sidibe said.

A report jointly released by the World Health Organization (WHO), UNAIDS and UNICEF on June 2 stated that by the end of 2007 nearly three million people in low- and middle-income countries were receiving AIDS drugs or antiretroviral therapy treatment (ART).

However, Sidibe said that new infections, unpredictable sources of funding and around six million AIDS patients still not receiving treatment undermine the achieved goals.

Annual AIDS infections in Uganda alone now stand at 130,000, up from less than 90,000 three years ago and the global total, mostly from Africa stand at 3.5 million, he said.

'There are many big challenges facing the world in the struggle against the spread of AIDS; people are on long-term treatment for up to 20 years,' he said. 'Resources for African countries come from outside. How will we have predictable and sustainable financing?'

Flavia Kyomukama, a Ugandan teacher who has been living with AIDS for 14 years, is worried that not enough resources are being allocated to stop infections rising.

'The struggle against AIDS is not satisfactory because we have failed to reduce the new infections,' the 38-year-old mother of three told dpa at the conference.

UN officials say that as more people are put on antiretrovirals, more demand for treatment is created, putting pressure on existing national health programmes that are in many cases already overburdened.

According to Sidibe, poor nations in Africa might fail to purchase the more expensive drugs in the 'second line treatment' that follows when the weaker 'first line treatment' drugs stop working.

Sidibe also said that action must be taken to extend treatment to all those who are eligible, but warned that preventative measures were absolutely essential.

'We know that any time we put two people on the drugs, we have five newly infected and so unless we deal with preventive treatment, the programs cannot be sustainable,' he said.

Doctors, social workers, people infected with AIDS, national policy makers, community-based workers and UN agencies at the Kampala meeting are expected to come up with measures to put before governments, UN agencies, multilateral and bilateral donors and groups involved in the control of AIDS.