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It started as a mysterious infection among gay white men but over two decades HIV/AIDS has exploded into the worst epidemic humanity has ever faced and is now afflicting as many women as men.
Ominously, the disease is also starting to take its toll on agricultural output and is worsening the food crisis in some of the world's poorest areas, according to the UN.
AIDS will have killed 3.1 million people by the end of this year, five million more have been infected with the deadly virus and 42 million people, half of them women, are living with HIV/AIDS, according to the latest figures from UNAIDS, the United Nations agency spearheading the battle against AIDS.
"For me what is most striking is that for the first time women comprise 50% of the global epidemic," Peter Piot, the head of UNAIDS, told Reuters on Tuesday.
"In Africa 58% of all people living with HIV are women. The face of AIDS is becoming the face of young women," he added in an interview ahead of World AIDS Day on December 1.
The changing dynamics of HIV/AIDS means more babies could become infected through their mothers and that women, who have traditionally been the carers, are being struck down with the illness that has afflicted their husbands, fathers and brothers.
AIDS hitting food output
AIDS is now contributing to other disasters, particularly in southern Africa which is most affected by the epidemic.
"It has exacerbated the food crisis. That is new. I think we are starting to see the true impact of AIDS in countries that are heavily affected," Piot said.
Drought and famines are not new to Africa but in countries where a quarter or a third of the population are ill, AIDS has intensified the problems they bring.
"Now it is much worse because agricultural production has gone down already because of AIDS, and nutritional requirements for whole communities have increased because people are sick and need more food," Piot added.
The AIDS Epidemic Update: December 2002 shows Africa, with 29.4 million people living with HIV/AIDS, is the worst affected region, Eastern Europe and Central Asia with 1.2 million cases has the fastest growing epidemic but Asia, particularly China and India is the real time bomb.
An estimated one million people in China are infected with HIV and unless effective responses take hold, the number could reach 10 million people -- equivalent to the entire population of Belgium -- by the end of this decade, the report says.
"It is truly an epidemic that is still on the rise," said Dr Alan Whiteside of the University of Natal in South Africa.
"It is not just a health crisis. It is a development crisis as well," he added at a news conference to launch the report.
In North America and Western Europe, the introduction of anti-AIDS drugs in 1995/96 caused a dramatic fall in AIDS deaths but the trend has begun to level off.
Researchers are also reporting an increase in unsafe sex and in heterosexual transmission of the virus.
Some good news
But Piot emphasised that more countries are showing evidence of the number of new infections declining. In South Africa the HIV prevalence rate among pregnant women under 20 years old fell to 15.2% in 2001 from 21% in 1998.
The report highlighted a similar decline in the virus among young inner-city women in Addis Ababa in Ethiopia.
"For the first time in years we have solid evidence that prevention can work even in the poorest countries," said Piot.
"There is far more money going into HIV activities than before. It is still not enough but at least there is progress there. That is what I would consider the good news part."
Drug companies have slashed the price of anti-AIDS drugs and countries like Botswana and Nigeria, and some corporations, are rolling out programmes to offer treatment to people with HIV/AIDS.
But Piot said only a tiny minority of people, mostly in the developed world, are receiving drugs.
"The price reductions are real but even at a dollar a day someone has to pay for it. We are focusing on training of physicians and nurses and finding the money for it. For the poorest countries it will only be possible if money comes from the outside," he said.
UNAIDS calculates that by 2007 the world will have to find about $15 billion a year to successfully treat and combat AIDS in low and middle income countries.
© Reuters
