A South African judge infected with HIV has accused industrialised nations of ignoring the Aids crisis in the same way that Germans and South Africans tolerated the horrors of Nazism and apartheid.

In his keynote speech to the International Aids Conference in Durban, Judge Edwin Cameron said although he could afford to pay for costly treatment, millions of Africans were unable to.

Cheaper drugs could help Africa fight Aids

"My presence here embodies the injustice of Aids because, on a continent in which 290m Africans survive on less than one US dollar a day, I can afford medication costs of about $400 a month," Judge Cameron said.

He said lower drug prices were essential if regions like the sub-Saharan Africa were to mount a challenge to the spread of Aids.

In Africa - south of the Sahara - 24.5 million people have HIV or full-blown Aids: more than 70% of the world total of 34.3 million.

Negative population growth

Experts says Aids will cause the population of worst-hit African nations to fall, marking the first time a disease has triggered demographic decline since the Black Death six centuries ago.

A leading US demographer predicts a negative population growth of one to three percent in South Africa, Zimbabwe and Botswana by 2003.

Judge Edwin Cameron said the availability of medication had made Aids "comparable with other chronic conditions" in the West, but in Africa the epidemic remained as fearsome as ever.

International agencies, national governments and... the international drug companies - have failed us in the quest for accessible treatment

Judge Edwin Cameron

"International agencies, national governments and especially those who have the primary power to remedy the inequity - the international drug companies - have failed us in the quest for accessible treatment," he said.

Mbeki criticised

The judge charged the government of South African President Thabo Mbeki of being "inept" in dealing with the problem of Aids and HIV.

He said Mr Mbeki's "flirtation" with those claiming that the HIV virus did not cause Aids "has shaken almost everyone responsible for engaging the epidemic".

The South African president had reiterated this view while inaugurating the conference.

He said poverty and not Aids was the most dangerous threat to the people of Africa.

Mbeki: Poverty, not Aids is the biggest killer

"As I listened and heard the whole story about our own country, it seemed to me that we could not blame everything on a single virus," Mr Mbeki said.

Hundreds of delegates walked out during his speech.

World Bank help

Meanwhile, the World Bank has proposed a $500m package for Aids programmes for Africa.

The bank said the funds would be available to nearly every country in Africa, but clarified that money alone is not an answer to Aids.

"The sobering reality is that Aids is not a health problem, but a serious development issue," said Callisto Mandavo, vice-president of the World Bank's Africa region.

"Only where governments show leadership can international support be effective."

The United Nations Joint Programme on HIV/Aids (UNAIDS) says about $3bn is needed for basic care and prevention in Africa.