Don't mention the new hope for AIDS to Satya Moorthy. "There is no point to this," he said. "There is no hope for most of us."

After contracting the human immunodeficiency virus (HIV) during surgery in 1991, the 27-year-old social worker in southern India heard about the new optimism in the fight against AIDS.For the vast majority of the world's 18.5 million people infected with the AIDS virus, there is a vast canyon of despair between First World hopes and Third World realities.

"None of the drugs are available in India, not even AZT," Moorthy said. "They are only available underground and they cost a fortune. Even the aristocrats cannot afford it."

This week in Vancouver, British Columbia, scientists at the International Conference on AIDS will discuss advances in treatment of the killer disease.

But for the estimated 16.5 million HIV-infected people in the developing world, no medical breakthrough can offer instant hope, not when a hospital bed is considered a luxury. For most, death remains cheaper than life.

In Moorthy's home city of Madras, unauthorized AZT treatment can cost $200 a month - far more than he and most other Indians earn in the same period.

With 90 percent of its infections in the Third World, HIV remains largely a health crisis for the world's poor. But despite the rampant spread of HIV across sub-Saharan Africa, South and Southeast Asia and Latin America, the developing world remains largely ignored in the global fight against AIDS. Only 8 percent of AIDS-related spending occurs in the Third World.

To take the fight to new frontiers in the developing world, a new United Nations AIDS organization has been created, but its task remains daunting. Between them, Mexico and Brazil already have more than one million HIV-infected persons. India now houses the world's largest HIV-infected population, numbering 1.8 million, which is projected to rise to 3.9 million by the end of the decade.

In Thailand, AIDS hBut itwod 120,000 lives. And as the virus races through neighboring Cambodia and Burma, the U.N. warns that Asia, with its population density, rapid industrialization and mass migration to cities, will soon be the new center of the AIDS pandemic.

But itworld's poorest continent, that AIDS continues to inflict its greatest damage. According to the World Health Organization, fully three-quarters of the world's estimated six million AIDS cases can be found in Africa - a number that is expected to soar in coming years.

The WHO identifies 15 African countries in which 5 percent or more of the adult population is infected, a rate which the World Bank says will cut average life expectancy by a full 15 years.

The worst hit: Botswana, Zambia and Zimbabwe, where nearly one in five adults carry the AIDS virus. In many of those countries, however, cash-strapped health programs can't even keep pace with meeker diseases such as measles.

The world's poorest countries last year recorded 42 million cases of measles and 40 million cases of whooping cough - each deadly when they strike in an impoverished household.

Although the WHO ranks AIDS as only the seventh-largest killer in the world, the virus is now combining with many ancient scourges to pose an even more formidable challenge to developing countries.

In India, where an estimated 40 percent of the population carries the tubercle bacillus, the risk of a latent TB infection becoming active is estimated to be 10 times stronger among HIV-infected persons. Recent estimates suggest about a quarter of new TB cases are HIV-positive. In parts of Africa, more than 40 percent of AIDS patients suffer from tuberculosis.

Effective but expensive treatments for tuberculosis remain beyond the reach for most people in developing countries.

Facing such grim prospects, many Third World governments have lobbied for a massive shift in AIDS-related funds to developing countries.

But many activists believe the Indian government has proved why governments in developing countries should not be entrusted to stop the rising tide of AIDS.

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With a low-interest, $100 million loan from the World Bank, India's Health Ministry has little to show. Many of its 150 new blood-testing centers still lack basic testing kits. Its public-information campaigns remain ignored by most of the public. Its free condoms serve mostly as balloons for children.

J.S. Gill, a doctor with New Delhi's Center for Community Medicine, which runs an AIDS program for non-government organizations, said that "AIDS education is the kind of work governments are not very good at."

"I have no degree of optimism," Gill said. "We had a five-year head start and still today nothing is being done. It's a sad story. India has failed to rise to the challenge of AIDS."

(Distributed by Scripps Howard News Service.)

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