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The global AIDS epidemic reached twin peaks this year, making 2003 the grimmest year in the epidemic's history, according to new estimates Tuesday.
Approximately 5 million people worldwide were infected with HIV in 2003, compared with about 4.7 million last year, and epidemics were gathering momentum in India, China and Eastern Europe. About 3 million people died, compared with 2.8 million people in 2002, says the report, ''AIDS Epidemic Update 2003.''
''What was striking to me is that this year there were more infections than ever before,'' says Peter Piot, director of the United Nations Joint Programme on HIV/AIDS (UNAIDS), which carried out the analysis. ''I had hoped we'd be able to give better news.''
An estimated 40 million people worldwide are living with HIV, the report says. Although that statistic is largely unchanged from previous years -- and may seem to reflect a static epidemic -- it masks the tragic cycle of new infections and deaths that now exist in countries with older epidemics.
Given the lack of treatment, it's no wonder the death toll is rising, Piot says. The AIDS virus quietly multiplies for years before the immune system crashes. Once that happens, people usually live about 18 months. ''We're seeing more and more people dying from infections that happened years ago,'' Piot says.
Eric Goosby, medical director of Pangaea Global AIDS Foundation, a non-profit agency that focuses on treating patients in the developing world, says sub-Saharan Africa is likely to see several waves of deaths because the bulk of the population is in the latter stages of disease.
''In the next three to five years, the biggest wave will hit the beach,'' he says. ''The only thing that will stop it is treatment.''
Paradoxically, Goosby says treatment preserves lives, families and national economies but doesn't save money, because many patients need lifetime therapy.
''In every country that has introduced (HIV drugs), you have a 40% to 50% drop in deaths, and the number of people living with HIV goes way up. The cost of the epidemic is only going to grow.''
Piot says the global response remains ''entirely inadequate.'' The World Health Organization has pegged the global cost of AIDS prevention and treatment at $10.5 billion a year.
A House-Senate conference committee agreed Monday to spend $2.4 billion next year on the Bush Global AIDS Initiative, including $400 million in new funding. The White House requested $200 million for WHO's Global Fund for HIV, TB & Malaria, but the Senate doubled the amount.
All nine Democratic presidential candidates say they will spend $30 billion, twice Bush's five-year pledge, on global AIDS if elected, says David Bryden of the Global AIDS Alliance, an activist group.
On World AIDS Day this coming Monday, WHO is expected to release details of its initiative to treat 33 million people by 2005. The cost: about $5 billion a year.
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