Full impact of AIDS yet to be felt - UN commission

Africa must brace itself for "the AIDS time bomb" that has killed 20 million people but whose full impact could still be a decade away. According to a special commission set up by United Nations Secretary-General Kofi Annan, the continent faces millions more deaths and orphans.

"If we think we are seeing an impact today we have to brace ourselves because it is set to get very much worse in the future," warned Professor Alan Whiteside, a member of the 20-strong Commission on HIV/AIDS and Governance in Africa.

The commission called for a massive scaling-up of treatment to prevent "the collapse of societies under the weight of the pandemic". It said only 50,000 Africans were getting potentially life-saving anti-retroviral treatment (ARV), yet four million were in need.

The World Health Organization aims to ensure three million people worldwide get access to ARVs drugs by next year under their three-by-five initiative, the conference heard. It was also told that the virus was fuelling a massive drop in life expectancy.

"The AIDS epidemic is cutting a swath through our societies," added Whiteside, an AIDS economist from the University of Natal in South Africa.

Former Zambian president Kenneth Kaunda, whose son died of an AIDS-related illness in 1986, made an impassioned appeal to world leaders to help do more.

"There is no sector that has been spared by the AIDS pandemic," he told several hundred health experts and politicians in the Ethiopian capital, Addis Ababa. "African governments do not have the capacity to sustain treatment programmes at national level. They need the support and assistance of the international community in order to scale up treatment programmes in a sustainable manner," he added.

Commissioner Pascoual Mocumbi, the former Prime Minister of Mozambique, told the conference that the challenge facing the continent was to keep infected people alive.

"The very future of our society is tied to keeping these people alive," he said. "There is no escaping that the loss of teachers, health workers and civil servants at the rate witnessed today threatens the eventual collapse of society."

Some 20 million people in the world have died since the start of the HIV/AIDS epidemic, according to UNAIDS. Another 29.4 million are living with the virus and 25 million children orphaned.

Earlier this year UNAIDS revised estimates of the annual cost of combating HIV/AIDS from US $10 billion to $12 billion.

"There appears to be a stabilization in HIV prevalence rates, but this is mainly due to a rise in AIDS deaths and a continued increase in new infections," UNAIDS said. "Prevalence is still rising in some countries such as Madagascar and Swaziland, [but] is declining nationwide in Uganda," according to UNAIDS's 2004 annual report.