The failure of political leaders to invest massively in the battle against HIV/AIDS is tantamount to genocide, says the president-elect of the International AIDS Society.

"If you have evidence your inaction is responsible for millions of deaths, you promise to correct that situation, then you fail to deliver, what do you call that?" Julio Montaner said in an interview.

"It's not ignorance. It's not mere negligence. It's more than a crime against humanity.

"It can only be characterized as genocide."

Dr. Montaner, director of the B.C. Centre for Excellence in HIV/AIDS in Vancouver and one of the world's leading AIDS researchers, said that life-extending drug cocktails must be made available to everyone in the world who is infected and would benefit, regardless of the cost.

"These drugs are so powerful that we have a moral imperative to make them available," he said.

There are an estimated 38.6 million worldwide living with HIV/AIDS, according to the United Nations agency UNAIDS. According to data presented at the 16th International AIDS Conference, 1.6 million people are getting antiretroviral drugs in developing countries and as many again in the developed world. Worldwide, only 21 countries (including Canada) are providing the treatment to at least half of patients who could benefit.

"These are unacceptable levels," said Cristina Pimenta, the former head of the prevention unit of the Brazilian National AIDS Program. "We are moving backwards every day."

What she means is that the number of new infections -- 4.1 million last year -- is far outpacing the number being newly treated.

Similarly, the cost of treatment and prevention is significantly higher than the spending commitment of governments.

Last year, an estimated $8.7-billion was spent on HIV/AIDS, about half of what is required to provide basic treatment, prevention and care.

Providing drug cocktails to everyone would cost an estimated $7-billion annually, and as much again for related testing and health care.

Mark Heywood, national secretary of the Treatment Action Council in Johannesburg, South Africa, said that the failure to provide treatment to people with HIV/AIDS should be a violation of fundamental human rights.

"We have the means, so what stops us from acting?" he said. "And what should be done about those in power who refuse to act? These are the most pertinent questions facing the next stage of the AIDS epidemic."

Mr. Heywood said vague promises to act are not enough, that the United Nations must, by year's end, set firm targets for delivery of antiretroviral drugs and reduction of mother-to-child transmission of the disease.

He also called on delegates to hold politicians' feet to the fire to ensure they deliver.

Previously, the United Nations vowed to get AIDS drugs to three million by the end of 2005. They fell short of that target, in large part because countries like Canada failed to come through.

Two years ago, Canada adopted legislation becoming the first Group of Eight country to allow generic pharmaceutical companies to export life-extending medicines to developing countries that don't have the capacity to manufacture drugs themselves, but not a single pill has been delivered.

The AIDS conference, which has attracted 31,000 participants, wraps up today. The closing plenary will feature a keynote address by Stephen Lewis, the UN special envoy for HIV/AIDS in Africa.