United Nations Secretary General Kofi Annan has warned world leaders that the financial and political response to the HIV/Aids epidemic has been woefully inadequate.
Few Africans have access to anti-Aids drugs
"We are not on track to begin reducing the scale and impact of the epidemic by 2005," he told a 191-nation assembly gathered to review progress on the disease.
A report presented to the assembly outlined shortfalls on a number of fronts, including expanding access to lifesaving drugs, caring for Aids orphans, preventing discrimination and blunting mother-to-child transmissions of the disease.
UN goals set three years ago included having three million HIV-positive people in the developing world taking Aids drugs by 2005 and halting and reversing the epidemic by 2015.
Only 300,000 people in developing nations now have access to drugs, although UN figures estimate that between five million and six million people have full-blown Aids and need them.
At the opening of another major international Aids conference in Nairobi, UN special envoy on HIV/Aids Stephen Lewis has denounced , as a "grotesque obscenity" the lack of cheap anti-Aids drugs in Africa.
He condemned the behaviour of Western powers, saying "we can find over $200bn to fight a war on terrorism, but we can't find the money... to provide the anti-retroviral treatment for all those who need such treatment in Africa!"
Just $1bn was spent on combating Aids in Africa last year, he said.
An estimated 30 million people in Africa are infected with HIV - the virus that causes Aids - and some 15 million have already died from the disease.
The World Health Organisation (WHO) wants three million people across the continent to receive anti-retrovirals by 2005.
The drugs do not cure HIV but they can delay its progress, giving sufferers the hope of a longer life.
Although the prices of anti-Aids drugs have fallen dramatically, only about 50,000 African sufferers have access to them.
Experts say the big problem now is how to distribute the drugs efficiently through Africa's ramshackle public health systems.
A new UN report, released at the start of the conference, described the Aids epidemic as the biggest challenge to improving the lives of people in Africa.
Thousands of doctors, politicians and Aids activists are in Nairobi for what is seen as an important opportunity for Aids experts to exchange ideas about best practice.
The International Conference on Aids and Sexually Transmitted Infections in Africa (ICASA) is held every two years.
The latest UN update praised some countries on Sunday but warned others who were floundering in the face of the rampaging pandemic.
"They now need to apply this experience and knowledge more extensively. There are key gaps in most African national responses that deserve special attention as action against Aids in Africa is brought to scale."
The WHO and charity Medecins sans Frontieres found that government involvement in fighting the disease was critical.
The report contrasted the national anti-Aids plan implemented in Malawi with the weaker official response to the crisis in Kenya, where cheaper drugs are not widely available.
Key points in the report are:
The biggest concern about HIV/Aids is in southern Africa. In Botswana, for example, nearly 40% of the adult population is HIV positive.
It sounds an alarm for pregnant women in southern Africa. The WHO found that more than one in five tested at the end of 2002 had the Aids virus.
The situation in East Africa is improving. The overall prevalence of HIV/Aids there "is slowly declining," the report said.
Praise was lavished on several countries in West Africa,
which has the lowest prevalence rate of Africa's sub regions.