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.