The 10th International Conference on AIDS ended here on Thursday with no major breakthroughs reported and with the world's researchers still far from defeating the foremost new medical threat of the decade.
Meanwhile, the epidemic marched on.In the five days it took to conduct the conference, an estimated 41,000 people around the world became infected by the virus that causes the disease.
The grim statistic underscored the contrast that became clear this week between the rapidly spreading epidemic and the slow pace at which efforts to fight the disease are progressing. Neither cure nor vaccine is expected by the end of the decade.
But as the conference ended on Thursday, participants said they could take some solace in the belief that painstaking advances are being made in basic science. Eventually, this may set the stage for a new assault on the disease.
"There's obviously some fatigue," Don de Gagne, a representative of the Global Network of People Living with HIV/AIDS, said on Thursday at a news conference. "There's nothing new. I think we have to acknowledge that. But we have to acknowledge that we're moving in small steps, in increments, and that is positive, too."
A mood of realism at this meeting evolved from the profound pessimism at last year's conference in Berlin, where results of clinical trials showed that AZT, the main AIDS drug, provided a limited benefit for a limited time.
When the first AIDS conference was held in 1985 in Atlanta, there were 9,285 cases of AIDS in the United States. Now there have been 402,000, with 243,000 deaths, according to the Federal Centers for Disease Control and Prevention.
Around the world, 4 million people, including those who have died, have developed AIDS, according to the World Health Organization. It estimates that about 17 million people have been infected with HIV, 3 million in the last year alone.
"We are only at the beginning of the HIV epidemic in the world," said Dr. James Curran, associate director for HIV/AIDS at the Centers for Disease Control and Prevention.
With a cure or vaccine far off, prevention is the best course, many experts said, especially in Asia, which is expected to become the new center of the epidemic.
Dr. Michael H. Merson, head of the World Health Organization's AIDS program, said that half the infections in Africa apparently occurred in the first four years of the epidemic.
"In places where the epidemic is just moving into the early explosive phase - like much of Asia - the overriding need is to act now, without delay, to prevent or blunt the rise in infections," he said. Merson said that 5 million infections could be avoided in Asia by the year 2000 for an expenditure of $1.5 billion a year.