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HAVANA, Apr. 8 - Latin American and Caribbean countries must double the $1.2 billion they spend yearly in fighting AIDS  to treat the disease effectively and keep it from spreading, an official said at a U.N. conference Tuesday.

The money spent now "just isn't enough" said Nina Ferencic, a program development adviser for the U.N. AIDS agency UNAIDS.

The funds — mostly from individual governments — should also be better allocated, she said. "Often, the distribution of the funds are discriminatory and the groups most at need don't get the money: men having sex with men, intravenous drug users," Ferencic added.

There are nearly 2 million people with AIDS or HIV in Latin America and the Caribbean, regional AIDS specialists said.

With an adult HIV incidence of 2.3 percent, the Caribbean is second only to sub-Saharan Africa in the scope and impact of the epidemic, according to UNAIDS. HIV/AIDS is the leading cause of death in several Caribbean countries, including Haiti and the Bahamas, the agency said.

President Fidel Castro (news - web sites) attended, but did not address, the Tuesday evening inauguration of the conference. He met Monday night and Tuesday afternoon with Dr. Peter Piot, executive director of UNAIDS, who is leading the conference.

A UNAIDS news release quoted Piot as saying that progress has been made to ensure care and treatment for people living with HIV/AIDS in Latin America and the Caribbean, but gaps remain and the money to fight the epidemic is unevenly distributed.

Piot said recent international funding includes $155 million through the World Bank 's Multi-Country HIV/AIDS Prevention and Control Project for the Caribbean and $325 million through the Global Fund Against AIDS, tuberculosis and malaria, covering 11 countries over five years.

"The challenge now is to continue this momentum and for governments to spend the money effectively and efficiently," Piot said.

Copyright © 2003 The Associated Press

PORT-AU-PRINCE, Haiti, Apr. 7 - The emaciated men lie in hospital cots, straining to breathe and moaning in pain as AIDS  drains away life.

Many arrive at the clinic so weak they are carried in wheelbarrows. Without access to modern health care or lifesaving drugs now common in wealthier countries, the patients can only wait for death.

Some last months, others only days.

"I'd like to be able to live again," said 43-year-old Wilfrid Jean-Baptiste, cringing as a volunteer pricked his arm with an IV needle. Soon afterward, he was dead.

With an estimated 300,000 of Haiti's 8.3 million people infected, AIDS is the leading cause of death for sexually active adults, killing thousands each year.

But doctors say many more can be saved with the help of a new $25 million grant from the U.N.-initiated Global Fund to Fight AIDS, Tuberculosis and Malaria.

The first disbursements reached nonprofit groups in Haiti in March. Over the next two years, the money is to be used to help expand prevention and treatment programs and buy antiretroviral medicines for thousands of new patients.

A proposal by President Bush, still to be approved by Congress, would devote an additional $15 billion to fighting AIDS over the next five years in Africa and the Caribbean, including Haiti.

Bush calls the plan "a work of mercy." International negotiations have drastically reduced prices of AIDS drugs, but they remain out of reach for most Haitians, who often struggle to survive on $1 a day or less.

It costs $2,000 a year to treat one patient with the life-giving antiretroviral cocktail.

So 37-year-old Maria Malo has quickly exhausted her savings and the generosity of family and friends. The white-and-yellow pills have taken away her diarrhea and given her strength to care for her 9-year-old son, but she doesn't know how she will pay for the next batch.

"I mainly ask God to help me survive so that I can take care of my child," said Malo, who was a nurse until the disease prevented her from working.

At the Missionaries of Charity Brothers clinic, a dozen men with advanced AIDS waste away in cots, some hacking with tuberculosis.

Volunteers treat their pain and symptoms, but death comes often. More than a dozen have died there this year.

It doesn't have to be this way. Danielle Penette, who runs the Rainbow House home for AIDS orphans, has seen sick kids come back to life in days with antiretroviral drugs.

"It was like a flower drying and blossoming again," said Penette, who buys drugs with UNICEF funds for 15 of the 30 infected children.

The Caribbean has the world's second-highest infection rate — 2 percent — after sub-Saharan Africa. The figures exclude Cuba, where screening and education keep rates low.

While Haiti accounts for most Caribbean cases, doctors say prevention programs are helping. Studies suggest the percentage of sexually active adults infected, now estimated at 4.5 percent, has been declining.

Money from the Geneva-based Global Fund will help train doctors and nurses to provide treatment and testing for HIV (news - web sites), the virus that causes AIDS. Money also will go to prevention programs.

"I think it's going to be a huge success," said Dr. Jean William Pape, whose Gheskio clinic treated more than 21,000 AIDS patients last year.

Pape, a professor of New York's Cornell University, will use $1.7 million from the fund to expand testing, treatment and counseling to 25 new centers in hospitals and clinics throughout the country.

The Global Fund also is sending $2.5 million this year to help a network of hospitals and clinics in Haiti's impoverished central plateau. Dr. Paul Farmer said the money should more than double the number of patients seen regularly there, to about 8,000.

His Boston-based nonprofit Partners in Health is already obtaining cheaper generic drugs, but urgent needs remain.

"We lose patients every week because we don't have enough meds," said Farmer, a Harvard Medical School professor.

In other areas, even simple care is unobtainable.

A $22.5 million loan approved by the Inter-American Development Bank would help reorganize Haiti's troubled health system, but it's part of $500 million in aid blocked since disputed elections in 2000.

Haiti's government is urging the loan's release to help fight AIDS. President Jean-Bertrand Aristide also criticizes the United States for blocking aid to the government.

Nevertheless, the United States is giving about $15 million to nonprofit groups for HIV/AIDS programs in Haiti over the next two years.

Stigma surrounding the disease still keeps many Haitians from discussing it or seeking treatment.

Some attribute it to evil spirits.

"I think the wind gave him the fever," said Marie-Michelle Pierre-Louis, who lifted a cup of water to the mouth of her emaciated boyfriend, Robinson Duroseau, at the missionaries' clinic.

Spending nights in the hallway with their infant son, she said she was hopeful the 24-year-old would soon be well. "God is going to make him OK," she said.

Four days later, he died. ___ On the Net: http://www.globalfundatm.org http://www.pih.org/wherewework/haiti  

Copyright © 2003 The Associated Press