4 July 2002 10:00 GMT

by BioMedNet News

International delegates gathering in Barcelona for the start of the world's biggest AIDS congress on Sunday received a stark reminder this week of the huge problems still to be confronted if they are to halt the spreading pandemic. The disease, which looks set to claim another 60 million lives or more before 2020, is still in its early phase, warned a new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS).

"HIV/AIDS is spreading rapidly in parts of the world where the epidemic had seemed stable or was previously confined to groups at highest risk of infection," noted Peter Piot, executive director of UNAIDS.

"Nations with accelerating epidemics must move quickly to adopt proven responses from countries that have succeeded in turning the epidemic around," he said when he presented the report to the 2002 session of the United Nations Economic and Social Council, in New York on Tuesday.

"Access to adequate care and treatment is a right, not a privilege," stated Piot. "Although real progress has been made in lowering the price of antiretroviral therapy in the developing world, far greater action is needed by both governments and the private sector to ensure that treatment reaches those in greatest need."

HIV prevalence is climbing higher than previously thought possible in the worst-affected countries and is continuing to spread rapidly into new populations in Africa, Asia, the Caribbean and Eastern Europe, says the report, which is subtitled "The Barcelona Report" and was released in advance of the XIVth International AIDS conference.

In Botswana, the country with the highest HIV infection rates in the world, almost 39% of all adults are now living with HIV, up from less than 36% two years ago.

Without drastically expanded prevention and treatment efforts in the 45 most affected countries, 68 million will die of AIDS between 2000 and 2020, which is more than five times the number of deaths during the previous two decades, notes the report.

In South Africa alone, there will be 17 times as many deaths among people aged between 15 and 34 than there would have been without AIDS, estimates suggest.

The report also notes how, in China, Indonesia, the Russian Federation and Western and Central Africa, HIV has moved beyond groups considered to be at highest risk of infection and is now spreading at an accelerated pace in the wider population.

"The success around the globe on preventing infection, and treating those already infected, demonstrates that it is possible to make progress against HIV/AIDS," said Piot. "But so far, these countries are the exception, and not the rule. In order to overcome this epidemic on a global scale, the international community must muster even greater political commitment, action, and above all, resources."

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