By Judy Aita
Washington File United Nations Correspondent

United Nations -- The global HIV/AIDS epidemic is worsening, according to a new UN report released November 28.

"We've estimated there's been an additional three million deaths in the past year, five million new infections, and perhaps a total of 40 million people currently living with HIV/AIDS," said Dr. Desmond Johns, the UNAIDS representative to UN headquarters in New York City, at a press conference.

The report, entitled "AIDS Epidemic Update, December 2001," was released to coincide with World AIDS Day December 1. In addition to the report, the UN will hold an international town hall meeting November 30 focusing on the role of individuals in responding to HIV/AIDS and the impact of the epidemic worldwide.

Dr. Johns said that UNAIDS sees both the report and the meeting as "a commemoration for those who have fallen victim to the illness, but also a celebration of life and a chance for those of us who have been involved to rededicate and reinvigorate our efforts."

According to the report, at the end of 2001 an estimated 40 million people globally were living with HIV. In many parts of the developing world, the majority of new infections occur in young adults, with young women especially vulnerable. One-third of those currently living with HIV/AIDS are between 15 and 24 years old.

Eastern Europe and the former Soviet Union currently experience the worst escalation of the epidemic, but the situation in Africa remains bleak with an estimated 3.4 million new cases in 2001, the UNAIDS official said.

"We've seen in Russia an escalation of some 15 fold in the number of estimated cases of HIV/AIDS in just three years," Dr. Johns said. "The epidemic is particularly worrying in Eastern Europe because it is one that affects the young people as they begin to experiment both with intravenous drug use and with sex."

While the number of new cases in Africa actually represents a slight slowing of the epidemic over the previous year, Dr. Johns said that in some parts of Swaziland, South Africa, and Botswana more than 30 percent of citizens are now infected or estimated to be infected.

"In West Africa, where we previously saw low rates of around 1 and 2 percent, we are now seeing figures suggesting a prevalence of around 5 percent, if not greater," he said.

Asia for the first time has seen the occurrence of more than 1 million new cases in a calendar year, Dr. Johns said. He pointed out that while the prevalence remains low compared to rates of infection in some other countries, some Asian countries have such large populations that "1 percent of 1.4 billion turns out to be a lot of people."

He also said that the overall low prevalence may, in fact, be misleading because in some cases it masks more severe epidemics in segments of populations, such as commercial sex workers and intravenous drug users.

The report said that in Asia and the Pacific an estimated 7.1 million people are now living with HIV/AIDS and 435,000 died of the virus in the region in 2001.

In the Middle East and North Africa, the number of people living with HIV now totals 440,000 with the epidemic's advance most marked in countries such as Djibouti, Somalia, and the Sudan which are already experiencing complex economic and political emergencies. While HIV prevalence is low in the region, increasing numbers of infections are being detected in Iran, Libya and Pakistan, the report said.

"In North America and Western Europe the overall levels remain very low, but there are worrying signs of resurgence of risk behavior. There have been an estimated 75,000 new cases in the developed world over the past year," Dr. Johns said.

An estimated 1.8 million adults and children are living with HIV in Latin America and the Caribbean, according to the report issued by UNAIDS. With an average adult HIV prevalence of approximately 2 percent, the Caribbean is the second-most affected region in the world.

"Increasingly we see AIDS as a developmental problem because it has its roots in many other social ills -- poverty, exclusion, discrimination, stigma," Dr. Johns said. He pointed out that the UN Development Program (UNDP) estimates that when the HIV/AIDS prevalence reaches 8 percent of the population, it translates into a negative GDP growth of one percent.

"In some areas 30 to 40 percent of the adult population (15 to 45 year olds) are, in fact, carrying the virus, living with HIV/AIDS. So when you're dealing with prevalence figures of around 10, 15, 16 percent, the extrapolations are quite clear," he said.

During 2001 the international community also made a commitment to increase efforts in HIV/AIDS prevention, treatment, and care. The June 2001 UN General Assembly Special Session on HIV/AIDS adopted goals for fighting the virus and every nation pledged to aim for a series of targets relating to prevention, education, treatment and care for those affec
ted as well as children orphaned by AIDS. A global fund established by Secretary General Kofi Annan has received about $1,500 million in pledges and the World Bank plans major new loans in 2002 and 2003 of over $400 million each year for HIV/AIDS.

The UNAIDS report also cautions against complacency and warns that time is fast running out if much larger AIDS epidemics are to be averted in some areas. In many regions of the world, the HIV/AIDS epidemic is still in its early stages, registering low national prevalence rates that might be misleading.

"All countries have, at some point in their epidemic histories been low-prevalence countries," the report noted. "HIV prevalence among pregnant women attending antenatal clinics in South Africa was less than 1 percent in 1990....Yet, a decade later, the country was experiencing one of the fastest growing epidemics in the world with prevalence among pregnant women at 24.5 percent by the end of 2000."