Catholic representatives attending the seventeenth International Aids Conference in Mexico City last week proposed that a global Catholic Aids network be set up to raise the profile of the Church's response to the HIV pandemic. The proposal comes amid signs of a greater appreciation outside the Church of the essential role played by church-based agencies in the fight against HIV and Aids.

During a speech to a gathering of 600 religious leaders that preceded the conference, Craig McClure, executive director of the International Aids Society which is the main sponsor of the conference, said: "Many faith-based organisations have been at the front line of the response to HIV since the very beginning. In the early years of the epidemic, some were the only groups willing to provide solace for the dying. When many others shunned those living with HIV and Aids, many Christians and people from other religions reached out with compassion to those in their communities who were in need."

Nonetheless, Mr McClure said, "The significant proportion of HIV services delivered by faith-based organisations across the world is not reflected in their influence globally, regionally and nationally on policy setting and regulatory processes. This must change."

However, he admitted that "lingering tensions ... particularly in the area of prevention" complicate making faith-based groups full participants in policymaking.

Mgr Robert J. Vitillo, special adviser on HIV for Caritas Internationalis, said on Thursday last week that the work of local churches is increasingly being acknowledged as making a vital contribution to combating Aids. "There is a growing understanding that a top-down approach [from governments] is not enough. Community-based faith groups are increasingly being recognised," he said. In addition, respected figures such as Harvard University's Dr Edward Green and Dr Daniel Halperin, also of USAID, the US Government's aid department, had now come round to an abstinence-based approach to HIV prevention, he said. He pointed to Uganda, Kenya, Ethiopia and Thailand as examples of where a programme of behavioural change had resulted in dramatic falls in infection rates.

While Mgr Vitillo complained about a lack of recognition and funds for faith-based HIV/Aids groups, he said more positive working relationships have been established with the World Health Organisation and a renewed Memorandum of Understanding has been agreed with UNAids.

Linda Hartke, coordinator of the Ecumenical Advocacy Alliance, a group that includes several American Catholic groups, remarked: "This [conference] isn't perceived as a friendly place to be a religious leader, but increasingly the faith community is being respected and taken seriously."

Among the 22,000 experts from around the world at the biennial gathering was the largest-ever contingent of Catholic groups. Catholic agencies provide a quarter of all HIV care in Africa. The conference discussed the effectiveness and implications of a programme of mass male circumcision to curb the spread of the pandemic in Africa. Studies suggest that circumcised men are 60 per cent less likely to contract HIV than uncircumcised men. But there were concerns that a circumcision programme could confuse the Church's traditional message of sexual responsibility and incorrectly make circumcised men think that they were immunised.

One of the successes referred to by Mgr Vitillo was the huge number of people now receiving antiretroviral drugs (ARVs). When Caritas first campaigned for access to them, they were widely considered by HIV/Aids charities to be too expensive.

Now, 3 million sufferers in the developing world are receiving them. This represents about 50 per cent of those in need. Caritas is now putting extra emphasis on the development and availability of ARV drugs designed to be effective for children.