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Global impact of AIDS greater than ever

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BANGKOK -- Global health officials scaled back estimates of the number of people infected with the AIDS virus, but said Tuesday that despite the statistical adjustment, the epidemic is expanding and killing people at a record rate.

The new calculations indicate that 38 million people worldwide are living with HIV, down from 40 million four years ago, according to a report by the Joint United Nations Programme on HIV/AIDS, UNAIDS.

Nevertheless, the epidemic's impact last year alone dwarfed any previous year, with an estimated 4.8 million new infections and 3 million deaths.

''Whether there are 38 million or 48 million, this is a catastrophe,'' UNAIDS deputy director Kathleen Cravero said here in a briefing before the 15th International AIDS Conference, which starts Sunday.

She added that the $5 billion now available for AIDS prevention and treatment falls far short of the $12 billion UNAIDS now says is needed to reverse the epidemic by 2005. Only 20% of people get prevention services, she said. Just 400,000 people worldwide get treatment.

Global AIDS estimates, rife with uncertainty, have often been targeted by critics who say that UNAIDS inflates its figures. UNAIDS director Peter Piot, reached in London, says UNAIDS has long acknowledged the uncertainty of its estimates.

The new analysis results from the use of more powerful statistical tools, improved household surveys of infection rates in rural areas, and a clearer recognition of regional differences in the proportion of infections among men and women, he says.

Infection rates were found to be lower than previous estimates in Uganda; Lusaka, Zambia; Nairobi, Kenya; Addis Ababa, Ethiopia; and Kigali, Rwanda, all places with long-standing prevention programs.

Asia Russell of the treatment advocacy group Health Gap says: ''It's not news to anyone that we need better tools to measure the epidemic. But we have to do more than count the dead.''

The picture remains grim in much of sub-Saharan Africa, where the epidemic appears to have stabilized only because as many people are dying as are becoming infected. In Eastern Europe, the epidemic grew by 46% during the past two years, with 1.3 million people infected, up from 900,000.

Several Asian countries in the most populous region of the world are teetering on the brink of epidemics.

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