The Bush administration, heavily influence by the Christian right, is blocking key proposals for a new United Nations package to combat AIDS worldwide over the next five years because of its opposition to the distribution of condoms and needle exchanges and references to prostitutes, drug addicts and homosexuals.
The United States is being supported by many Muslim countries, including Egypt, and various conservative African and Latin American nations. "There are a lot of unholy alliances all over the place," said a European official attending UN talks in New York last night.
Fraught negotiations were continuing to try to salvage as much of the package as possible. More than 140 nations are attending the UN summit in New York which began on Wednesday. The meeting is intended to update a 2001 declaration that provided the momentum for a worldwide campaign against AIDS. A new declaration is due to be agreed today.
Kofi Annan, the UN secretary-general, told the summit: "The world has been unconscionably slow in meeting one of the most vital aspects of the struggle: measures to fight the spread of AIDS among women and girls. These shortcomings are deadly."
A report published on Tuesday by the agency UNAIDS says new figures suggest the infection rate is slowing down globally, but new infections are continuing to increase in certain regions and countries.
The report adds that an estimated 38.6 million people are living with the AIDS virus, HIV; 4.1 million were newly infected last year; 2.8 million died of AIDS last year; and treatment with medicines is available to less than half of those infected withthe virus.
Of those infected worldwide, almost half - about 17 million - are women, and three-quarters of those are in Africa.
The British government, which has sided with Washington so often over the past decade, is in the progressive bloc at the summit, along with Canada and other European countries, and is diametrically opposed to Washington over its approach to AIDS.
Although the US is the world's highest spender in combating the virus, much of the money goes towards sex abstinence campaigns rather than the distribution of condoms or needle-exchange programmes.
Hilary Benn, the international development secretary, who flew to New York last night and will address the UN general assembly today, distanced himself from the US approach.
He said: "We have to take action on the evidence of what works, on what saves people's lives, and not on ideology. That means making condoms available and reducing harm to people at risk: injecting drug-users, sex workers and men having sex with men."
He said he hoped a declaration would be agreed today. "At the moment, one could say negotiations are deadlocked," he said. "I am concerned about that, but I do hope that we'll be able to find a way forward."
Sisonke Msimang, a spokeswoman for the Johannesburg-based Open Society Initiative for South Africa, one of hundreds of civil groups attending the summit, said: "It is not going forward." She added that America was among the key antagonists, saying: "America has been clear that it will oppose global targets. America says any mention of condoms has to be matched by abstinence and faithfulness."
The US is also opposed to increased funding targets. UNAIDS wants spending to be increased from £4.4bn a year on fighting AIDS to £12bn by 2010. But Washington has opposed this, preferring individual countries to set targets rather than the UN.
The Washington Post reported yesterday that the US government feared that if the target was set and there were shortfalls, it would be blamed.
The summit overrode the US funding objections yesterday, but negotiations were continuing last night over who will fund the £12bn target. The US wants conditions to be attached to funding, but is being opposed by the Europeans.
The Organisation of the Islamic Conference (OIC), which represents Muslim countries, vehemently opposes references in the declaration to homosexuals, prostitutes and drug addicts, saying these should not appear in a public document. The US is supporting the OIC.
The summit, held to mark the 25th anniversary of the first documented AIDS cases, is supposed to flesh out promises made at the G8 summit in Gleneagles last year to combat the virus. Diplomats involved in the negotiations were working late into the night in order to secure agreement for today's meeting, which is due to be attended by a number of heads of government and which is due to be opened by the US first lady, Laura Bush.