New U.N. report
paints grim picture of global AIDS epidemic

Almost 5 million people were infected by HIV globally in 2005, the highest jump since the first reported case in 1981 and taking the number living with the virus to a record 40.3 million, the United Nations said on Monday. The 4.9 million new infections were fueled by the epidemic's continuing rampage in sub-Saharan Africa and a spike in the former Soviet Union and Eastern Europe, the Joint United Nations Programme on HIV/AIDS says in its annual report.

"Despite progress made in a small but growing number of countries, the AIDS epidemic continues to outstrip global efforts to contain it," the report said.

More than 3.1 million people have died this year from AIDS, including 570,000 children--far more than the toll from all natural disasters since last December's tsunami.

Southern Africa, including South Africa--which has the world's most HIV cases at more than 5.1 million--continues to be worst-hit.

Saying nine out of 10 people in developing countries do not know their HIV status, UNAIDS executive director Peter Piot called for an unprecedented response to the global AIDS crisis.

"A business-as-usual approach will not do," he told a news conference in New Delhi. India, with about 5 million HIV-positive people, has the second-highest number of cases after South Africa, and there are concerns many cases are unreported.

Focusing on South Africa, where the infection rate among pregnant women reached 29.5% in 2005, the report said deaths of people aged between 25 and 44 had more than doubled. Other southern Africa countries such as Botswana, Lesotho, Namibia, and Swaziland had high rates of HIV among pregnant women--more than 30%. Sub-Saharan Africa is home to 25.8 million HIV-positive people, or 64% of the world's total.

In Asia, a total of 1.2 million new cases since 2003 pushed total cases to 8.3 million, with conditions in countries such as Vietnam and Pakistan ripe for a rapid spread.

UNAIDS said the number of HIV-positive women worldwide reached 17.5 million this year, more than 1 million more than in 2003. "In many countries, marriage and women's own fidelity are not enough to protect them against HIV infection," the report said, adding that in India many new infections were being reported in married women infected by their husbands who had visited sex workers.

In Eastern Europe, Central Asia, and the Russian Federation, infections due to unprotected sex are rising after the initial momentum given to the epidemic by injection-drug use. The report said a total of 1.6 million were living with HIV in 2005 in the region, up from 1.3 million in 2003, and AIDS deaths soared to 62,000 in 2005 from 36,000 in 2003.

Piot slammed the response in a region that has seen the number of infections rise 20-fold in a decade. "The response has been fragile and insufficient," he said. But he added that leaders across the world are far more aware of the crisis now and that spending to combat AIDS has reached $8 billion this year compared with $250 million in 1996.

"UNAIDS and governments should wake up and smell and the coffee," Anjali Gopalan, executive director of the Naz Foundation, a leading Indian HIV group, said. "If there is so much money, why can't we combat the disease? Why is there such a desperate situation? UNAIDS and governments must be made more accountable about where the money is going."

The outlook on accessibility of antiretroviral drugs for people in developing nations is looking brighter, the U.N. said. "Because of recent treatment scale-up since the end of 2003, between 250,000 and 350,000 deaths were averted in 2005," said the report. But it added that too many HIV-positive people are missing out, with just one in 10 Africans and one in seven Asians who need antiretroviral treatment actually receiving it.

Two decades into the AIDS epidemic, the report said that in many parts of the world, including southern Africa and South Asia, knowledge about HIV transmission is alarmingly low.

The outgoing chief of India's official National Aids Control Organization, S.Y. Quraishi, said 70% of Indian sex workers either do not know what a condom is or how to use one. "If the situation remains unchanged, India could have an estimated 50 million HIV cases by 2025," he said. (Reuters)