New evidence suggests that while countries in sub-Saharan Africa have the most people infected with AIDS - 14 million - the deadly virus may be on the verge of exploding in Eastern Europe, the former Soviet Union and other regions, the World Bank reported Monday.
A bank report recommended that governments act as quickly as possible with intensive prevention efforts, especially among people who have many sex partners or inject drugs using unsterilized needles.In many countries, government-backed prevention programs do not reach people with the riskiest behavior, said the bank, a leading international lending agency.
"In every country that now has a serious epidemic, people said, `It can't happen here.' They were wrong," said Martha Ainsworth, a co-author of the report, "Confronting AIDS: Public Priorities in a Global Epidemic."
"By the time that many AIDS cases are observed, it is too late to avert a serious epidemic. HIV (the AIDS virus) will already have spread widely," she said.
The 327-page report differs from many other studies analyzing the epidemic by focusing on how government decisionmakers should allocate resources to combat AIDS.
It said 23 million people worldwide now are infected with HIV, with 8,500 new cases each day. Approximately 90 percent of all HIV infections occur in developing countries, where resources to confront the epidemic are most scarce.
"Short of an affordable cure, this toll is certain to rise, the report said. "But the course of the epidemic is not carved in stone."
It said that "for the 2.3 billion people living in parts of the world where the epidemic is nascent, an early active government response encouraging safer behavior among those likely to contract and spread the virus has the potential to avert untold suffering and save lives."
Among countries in the early stages of the epidemic are Bangladesh, the Philippines, most countries from the former Soviet Union, much of Eastern Europe and parts of China and India, the report said.
More than 40 developing countries have "concentrated" epidemics where HIV is widespread among groups with the riskiest behavior but has yet to spread widely among other people. These include Pakistan, Ukraine, most of Latin America, parts of West Africa and most of Indochina, the study found.