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Wednesday, 28 November, 2001, 13:58 GMT
Forty million living with HIV
Globally, there are now 40 million adults and children with either HIV or Aids, according to the latest figures.

The epidemic shows no signs of abating - with the world on course for five million new cases in 2001.

The epicentre of the catastrophe remains sub-Saharan Africa, where more than 28 million people are thought to be living with the disease, and 2.3 million will die there in 2001.

The report from UNAids and the World Health Organisation says that approximately three million people worldwide are likely to have died from the disease by the end of the year.

The UN report is being published ahead of World Aids Day on Saturday.

2001: State of the Aids epidemic
HIV cases: 40m
37.2m adults
2.7m children
New infections: 5m
4.3m adults
800,000 children
Aids deaths: 3m
2.4m adults
580,000 children
Doctors are increasingly concerned about spiralling disease rates in other parts of the world, such as Eastern Europe - and say much more needs to be done to halt the spread in South and South East Asia.

Even in "high-income countries" such as the US and UK, where expensive anti-retroviral drugs are available, rates of new infections are creeping upwards.

Dr Peter Piot, executive director of UNAids, warned: "HIV is spreading rapidly throughout the entire Eastern European region.

"It is unequivocally the most devastating disease we have ever faced and it will get worse before it gets better."

In June, the UN made an unprecedented declaration of commitment to fight the Aids epidemic, calling for global action to curb its spread.

The primary goal of the campaign was to prevent new infections - by 25% in 15 to 24-year-olds over the next four years, and by half by 2010.

China crisis

A number of countries are singled out by the report as places where the virus is spreading exceptionally quickly.

In China, the total number living with the infection may have swelled past one million by late 2001.

There is increasing evidence of serious epidemics in that country.

In the Russian Federation, intravenous drug use is the driving force behind an HIV explosion over just the past few years.

In 1996, there were just a few thousand HIV cases reported - in 2001, the total is expected to be approximately 130,000.

However, the report says that political leaders are trying to address the problem there.

Budgets of national Aids programmes in Bulgaria, Romania, Russia and Ukraine have been boosted, setting a "positive example" for the rest of the region.

African tragedy

However, the tragedy of Sub-Saharan Africa dwarfs even the impending crises in Asia and eastern Europe.

Region by region: The HIV/Aids burden
Sub-Saharan Africa
28.1m cases - 2.3m deaths
South and south east Asia
6.1m cases - 400,000 deaths
Latin America
1.4m cases - 80,000 deaths
East Asia and Pacific
1m cases -35,000 deaths
Eastern Europe/ Central Asia
1m cases -23,000 deaths
North America
940,000 cases - 20,000 deaths
Western Europe
560,000 cases - 6,800 deaths
North Africa/ Middle East
440,000 cases - 30,000 deaths
Caribbean
420,000 cases - 30,000 deaths
Australia/ New Zealand
15,000 cases -120 deaths
In 16 countries in the region, at least 10% of those aged between 15 and 49 are infected - and in several southern African states, it is at least 20%.

"Aids has become the biggest threat to the continent's development and its quest to bring about an African renaissance," the report says.

"Essential services are being depleted at the same time are state institutions and resources come under greater strain and traditional safety nets disintegrate."

The epidemic is a serious threat to socio-political stability, it says.

Calculations suggest that the hardest-hit African countries could lose one-fifth of their Gross Domestic Product by 2010 as a result of Aids.

Average life expectancy in four countries - Botswana, Malawi, Mozambique and Swaziland - is now less than 40 years. Without Aids, it would be more than 60.

In the past year, the campaign to supply modern antiretroviral therapies to developing countries has gathered momentum, and forced concessions from some multinational drug companies.

However, the report says that prices remain "too high" for low-income countries, and that even if they could afford the drugs, their crumbling health infrastructures offer no means to distribute them effectively.

There is better news from some countries - the rate of new HIV infections has fallen substantially in some countries, such as Thailand, thanks in part to well-funded prevention programmes.

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The BBC's Greg Barrow
"There are few bright spots in this new report"
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