The UK yesterday signalled a major rift with the United States over its Aids policies, publicly rejecting the Bush doctrine that sexual abstinence is the best way to stop the spread of the pandemic.
The international development minister, Gareth Thomas, also made it clear the UK did not support the US over its reluctance to endorse the use of cheaper, generic drugs to fight the disease.
Arriving at the International Aids conference yesterday, where America has been relentlessly attacked by campaigners and criticised by UN agencies, Mr Thomas said that the UK was neither prepared to fall in with conservative American thinking nor sit on the sidelines.
His intervention came ahead of the launch by the prime minister next Tuesday of the government's own #1.5bn Aids plan. "We work with the Americans in a whole variety of ways, but we have a difference of view on abstinence-only campaigns," said Mr Thomas.
The Bush administration pledged $15bn (#8bn) to Aids over five years, but the vast bulk will go to programmes that stress abstinence. The ABC policy for Abstinence, Be faithful and Condoms "where appropriate" sits relatively comfortably with the religious right in the US and the faith groups working in the developing world who tend to be the Americans' chosen partners.
The Blair plan will focus on the reproductive rights of women and their need to protect themselves, recognising abstinence is frequently not an option in some of the worst-hit parts of the world, and that husbands are unfaithful.
The UK is a big funder of condoms, paying for 490m of the 1bn distributed in the developing world, and that, said Mr Thomas, "is not enough if we are to make an impact in preventing the spread of HIV/Aids".
He emphasised that the UK would continue to back the "excellent HIV, sexual and reproductive health work" of the UN Population Fund and the International Planned Parenthood Federation, both of which had their funding slashed by the Bush administration because they support sexual health clinics for women that include abortion services.
Ten days ago, Britain's Department for International Development announced #116m for UN Aids organisations, and in March it gave #12m to the federation.
The UK will also not side with the US over the use of cheap generic drugs made in developing countries such as India, which the US government refuses to accept are high quality even though they have been evaluated and approved by the World Health Organisation. The drugs are copies of medicines under patent to the world's biggest and richest pharmaceutical companies, most of which are based in the US. Campaigners point out that generics are far cheaper and will save more lives.
"One of the reasons we work with the international community is that we think the WHO and other organisations have the technical expertise so that countries through their ministries of health can make the decisions they want to about the drugs they use," said Mr Thomas.
The third point of conflict is over the Global Fund for HIV/Aids, Tuberculosis and Malaria which channels money from donors into programmes drawn up by developing countries. The Bush government has given only $500m of its $15bn to the fund, preferring to run its own projects. The chancellor, Gordon Brown, announced an unprecedented #1.5bn for Aids relief on Monday. Next week Mr Blair will announce that a substantial chunk will go to the Global Fund.
Last night Nelson Mandela came out of retirement to make a public appeal for more money for the fund. At an evening event where the Bill and Melinda Gates Foundation announced it would give another $50m, Mr Mandela called for substantially increased donations, as well as commitments to the fight against the pandemic. "Our inability to act decisively on this challenge is a direct reflection of our disregard for our common humanity," he said.
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