HIV: Global battle to conquer HIV 'may be lost': Ten years after the Aids virus was first identified, 17 million people are infected and the end of the epidemic is nowhere in sight

THE RACE to conquer HIV before it infects a substantial proportion of the world's population may have already been lost, and between 30 and 40 million people will be infected by 2000, the World Health Organisation warns in its latest analysis of the global crisis.

The number of estimated cases of Aids has risen by 60 per cent in the past year alone to reach 4 million, while the number of people infected with HIV now numbers about 17 million. More than 3 million of these are new infections from the past 12 months - at a rate of about 10,000 a day.

Sub-Saharan Africa continues to bear the brunt of the disease, but in south-east Asia, where infection was not reported until 1990-91, an estimated 100,000 people now have Aids. 'The end of the epidemic is nowhere in sight,' the WHO says as more than 10,000 scientists, doctors and people with HIV converge on Yokahama in Japan for the 10th International Aids Conference which opens on Sunday.

Ten years after HIV was first identified by Professor Luc Montagnier at the Pasteur Institute in Paris, the mood is one of pessimism and some wonder. Millions of pounds invested in research have revealed only the complexity of the virus and its effects on the immune system. A cure or preventive vaccine remain elusive and fundamental questions unanswered. Why do some people die soon after infection and others survive for 10 or more years, and how can some escape infection despite repeated exposure to the virus?

Scientists agree a rethink on their approach to treatment is urgent, and the Global Aids Policy Coalition at Harvard, in the United States, says complacency has taken root among politicians and the public in the developed world about the risks of HIV, while Third World countries have neither the knowledge nor the money to tackle the problem. 'The current strategy is outdated; it no longer has the conceptual power to mobilise people and resources,' the coalition argues.

Last week, British scientists predicted 20 years of Aids-free survival for up to a quarter of those infected with the virus. The most significant change in the next few years will be acceptance of HIV disease as a chronic illness - in contrast to early hysteria over the epidemic and headlines hinting that HIV was retribution for sin.

In the United Kingdom, 9,436 people had developed Aids up to June, and 22,101 people are HIV positive. Another 7,000 are probably infected and do not know it. Most cases are confined to the 'high risk' groups but heterosexual cases, particularly among women, continue to rise. The Public Health Laboratory Service will today publish data showing that the rate of HIV infection in pregnant women increased from 1 in 560 to 1 in 380, between January 1990 and June 1993.

Leading article, page 17

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