U.N.: 70 million will die of AIDS by 2022

AIDS could kill half of new mothers in some countries

WASHINGTON (CNN) -- With infection rates running higher than expected, the next 20 years of the AIDS epidemic will be far worse unless there is a marked increase in prevention and treatment, according to a new report from the United Nations.

"Twenty years [into] the AIDS epidemic ... 40 million people [are] living with HIV, 25 million have died, and if we continue with the current low level of response in many countries, we can be sure that in the next 20 years that close to 70 million people will die because of AIDS," said Dr. Peter Piot.

Piot is director of the Joint U.N. Program on HIV/AIDS that released a report Tuesday saying that with the global epidemic still in an early phase, the number of infections is far exceeding predictions.

The level the epidemic would reach has been consistently underestimated for the past five to 10 years, according to Neff Walker, senior epidemiologist for UNAIDS. In particular, prevalence rates in southern and eastern African nations were off by 30 percent to 50 percent.

Young people at greatest risk

Historically, most diseases have leveled off after the at-risk groups were infected, and experts have long expected a similar pattern with AIDS.

When the numbers showed new infections were still rising in the hardest hit countries, Piot said, it confirmed AIDS is the largest epidemic in human history.

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"In Botswana, for example, two years ago about 36 percent of adults were HIV-positive," Piot said. "Today this is 39 percent, nearly 40 percent of all adults."

The report said the epidemic continues to spread in almost every part of the world, with young people at greatest risk for infection.

It is estimated that half of all those newly infected are ages 15 to 24. Almost 12 million young people are now living with HIV, and about 6,000 more are infected every day, the report said.

As adults die in developing countries that don't have access to the powerful AIDS medicines, the number of AIDS orphans is rising.

According to the report, 14 million children have lost one or both parents to AIDS. In some countries, it is estimated up to half of new mothers could die from the disease.

The disparity between rich and poor countries is seen most clearly in the availability of AIDS drugs that have virtually saved many of those who can afford them.

Piot said that in the West a half-million people are under HIV treatment and last year 25,000 people died from AIDS. In Africa only 30,000 people are under treatment and last year 2.2 million died.

"It's one of the greatest injustices in the world today," Piot said. "Without massive treatment programs there won't be people left in the most affected countries to organize prevention programs, to teach in the schools, to organize the farms, to lead the country."

But there are signs that things are changing.

In Brazil, the government program to provide medicine to those who need it has turned around the epidemic.

Several countries in Africa are following Uganda's lead and launching aggressive campaigns.

The government of Botswana, for example, is starting a program to get AIDS drugs to those who need it. Botswana has the highest prevalence of HIV in the world.

The key issue centers on money for such programs.

"The world needs $10 billion a year to treat those with HIV in the poor nations, to make sure that the number of new infections is going down dramatically, and to take care of orphans," Piot said. "Today we're at the $3 billion mark.

The UNAIDS report was released just before the start of the International AIDS Conference, which opens Sunday in Barcelona, Spain.