"We are not on track to begin reducing the scale and impact of the epidemic by 2005," Secretary-General Kofi Annan said in a speech to open the U.N. session.

Without more money and more political will, it is unlikely the goals of having 3 million HIV-positive people in the developing world taking AIDS drugs by 2005 and halting and reversing the epidemic by 2015 will be met, experts said.

There are only 300,000 people in the developing world with access to medication, although between 5 million and 6 million individuals need the drugs, the report said. Brazil, which has a widely heralded AIDS program, accounts for more than one-third of the patients in the developing countries who are receiving treatment. In sub-Saharan Africa, only an estimated 50,000 people receive medication when 4.1 million require them.

Experts say there has been no slowdown in the progression of the disease, which affects 40 million people, about 29 million of them in Africa. If the response to the pandemic doesn't improve, UNAIDS estimates there will be 45 million new infections by 2010. China, India and Russia are among the countries were AIDS is rising rapidly.

There are few indications that the financial commitment is increasing enough to fight the epidemic. UNAIDS estimated there is a $1.6 billion gap this year between projected spending and what AIDS programs need.

"We are getting further and further behind because the demands for prevention and especially treatment for the disease is increasing faster than our resources," said Paul De Lay, director of monitoring and evaluation at UNAIDS, which wrote the Progress Report on the Global Response to the HIV/Epidemic.

The report was written using information submitted by 103 of the 189 countries that signed the Declaration of Commitment on HIV/AIDS that was adopted at the 2001 session.

The report renewed activists' accusations that the United States is failing to do its part to fight the pandemic. Although the Bush administration has promised $15 billion over five years to combat AIDS abroad, Congress has only earmarked $2 billion of the $3 billion available for 2004.

Moreover, Bush has only requested $200 million for the Global Fund to Fight AIDS, Tuberculosis and Malaria. The fund, established after the 2001 AIDS meeting, is a major source of money for treatment and prevention programs. It has $4.6 billion in pledges through 2008, but only 23 percent of its needs through 2004 are met by those funds.

"For the U.S. to be sitting with a fiscal 2004 appropriation for the fund of $200 million absolutely makes no sense," said Jeffrey Sachs, an adviser to U.N. Secretary General Kofi Annan.

White House spokeswoman Suzy De Francis said new federal laws prevent the United States from giving more than one-third of the fund's money, and currently U.S. contributions account for 40 percent of its assets. She said the U.S. can't give the $200 million unless the rest of the world increases its share.

De Francis added the U.S. will only spend $2 billion instead of $3 billion on AIDS next year because the Bush administration wants to make sure there are policies and infrastructure available in the developing world to use the money wisely.

Overall funding for HIV/AIDS has increased. This year, spending on HIV/AIDS programs in the developing world will reach US$4.7 billion — a 20 percent increase over 2002. Increases have come from both international donors and the affected countries themselves.

"Yet we are still only half way to the $10 billion a year that is needed by 2005," Annan said.

De Lay said there were some glimmers of hope in the report. The declaration required all countries to develop a national AIDS strategy by 2003. Ninety-three percent say they have accomplished that goal. Countries were also supposed to have a strategy to provide care for HIV-affected individuals by 2003, and 76 percent of countries had such policies in place.

The 2001 declaration resolved that by 2005 at least 80 percent of pregnant women should have access to information, counseling and treatment to prevent HIV transmission to their children. The report said, that except for Botswana, less than 1 percent of pregnant women in heavily affected countries have access to such services.

HIV and AIDS has left more than 14 million children under the age of 15 without at least one parent. The declaration said that by 2003 countries should have developed and by 2005 implemented policies to support the orphans. Yet, 39 percent of countries with epidemics have no national policy to support for these children.

By Evelyn Leopold

UNITED NATIONS (Reuters) - Despite more money and a myriad of programs, most nations are unable, unwilling or too impoverished to provide treatment or prevention plans that could reverse the AIDS pandemic by 2015, U.N. officials said.

At an all-day conference on Monday, U.N. Secretary-General Kofi Annan said new reports from 103 government delivered a series of bleak statistics, showing action fell "far short of what is needed."

Some 136 delegates, including heads of state and foreign ministers addressed the General Assembly, with representatives from Chile, Benin and others speaking well after midnight.

Dr. Peter Piot, head of UNAIDS, which coordinates programs among U.N. agencies, told a news conference, said "there isn't a single A in the report card."

World leaders at a special General Assembly session on AIDS in June 2001 pledged to halt and reverse by 2015 the pandemic that has cost 28 million lives, 3.1 million last year alone.

But Piot estimated there would be 45 million new infections by 2010 and emphasized denial was still a problem because of the disease's transmission through sexual intercourse.

One goal was to ensure by 2005 that at least 80 percent of pregnant woman have information, counseling and drugs to prevent transmission of HIV, the virus that causes AIDS. But such services hardly exist in countries that need them most, the new report card showed.

"The pandemic is galloping out of control," said Richard Feachem, head of the Global Fund to combat AIDS, tuberculosis and malaria, set up by the United Nations and leading industrial nations two years ago.

Funds for AIDS spending in the last two years have increased 20 percent to $4.7 billion in low and middle-income countries, with 57 percent from foreign sources.

But Piot said $10 billion was needed by 1995 if the disease were to be reversed.

DRUGS FOR 3 MILLION PEOPLE

In an attempt to make a dent in the statistics, the World Health Organization wants to provide drugs to 3 million people, most of them in Africa by the end of 2005. About 6 million people of the 42 million infected worldwide have full-blown AIDS symptoms.

If successful, the WHO plan would be close to four times the total covered by existing programs.

WHO Director-General Dr Lee Jong-Wook called on the world to make AIDS a global emergency, to be tackled with the same urgency as flood, earthquakes -- and the SARS outbreak.

The agency intends to send teams to various countries to assess what kind of treatment plan is needed and then use its own funds and appeal for others to get programs started.

Brazil, which for the past decade had the world's most successful AIDS treatment program among developing nations, has discovered poor patients are better at following pill regimens than Americans and Europeans. Studies in Africa have produced the same results.

But an official of the World Food Program said the discussion on AIDS focused on medical solutions and drugs to the exclusion of everything else.

"We have to find a way to look after those who are already infected, whose lives are falling apart and whose ability to be productive is really in doubt," said Trevor Rowe.

"They need assistance. They have to be part of the debate. They need nutrition. If they have medicine they need food as well," he said.

NAIROBI (Reuters) - The World Health Organization(WHO) said on Wednesday the lack of access to anti-AIDS  drugs was a global health emergency.

It said only five percent of the six million people with HIV in developing countries who would benefit from anti-retrovirals (ARVs) were being treated.

In sub-Saharan Africa, where most of those people live, only about 50,000 are receiving the long-prolonging drugs, WHO said.

"WHO is declaring the lack of access to ARVs a global health emergency," Dr Paulo Teixeira, director of the WHO's HIV/AIDS department, told reporters at the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA).

He said WHO was calling on all its partners to adopt its "three by five" target -- three million patients on ARVs by the end of 2005.

"We have to do everything we can to reach this target," he said. "This situation cannot continue anymore."

The United Nations AIDS group estimates that 38.6 million adults worldwide were living with HIV/AIDS at the end of 2002, of whom an estimated 29.4 million were in sub-Saharan Africa.

Dr Peter Piot, UNAIDS executive director, said the ambitious "three by five" plan would cost at least $5 billion a year, in addition to the $10 billion already being spent annually.

NAIROBI (AFP) - Raped or coerced into unprotected sex, denied justice or rights by law or tribal practice, lacking access to health care and education: women are clearly the biggest victims of Africa's AIDS crisis, experts warned.

Grassroots workers attending an international conference on AIDS in Africa unleashed a torrent of stories of abuse against women and girls, describing it as one of the biggest barriers to tackling the continent's terrifying pandemic.

Of the 29.4 million people with AIDS or the human immunodeficiency virus (HIV) in sub-Saharan Africa, 58 percent are female, according to the latest figures compiled by the UN agency UNAIDS.

Campaigners are astonished and dismayed by this imbalance, and even more so by the even higher comparative rates between young men and girls.

One possibility being explored is that women may be clinically more vulnerable to HIV than men.

But another factor -- and a certain one -- is that African women and girls are far more vulnerable to being infected with HIV by men than in developed countries, and have far less chance of getting treatment or legal redress.

The risks include rape by relatives or teachers, or by soldiers in war zones, and coercive sex by a husband who has been infected by unprotected intercourse with a prostitute, said Nomfundo Dubula, a South African worker with the organisation Medecins Sans Frontieres (MSF, Doctors without Borders).

"Men in my country do not like to wear a condom, and women are afraid to deny them sex. They fear they will lose their man, that he will leave her and find another girl," she said.

Keletso Makgekgenene, a lawyer and HIV campaigner in Botswana, said one of the biggest problems in her country was the "virgin myth" -- that infected men believed they could free themselves of HIV if they had sex with a virgin.

That had prompted a rush of older men to ply younger women with clothes, jewellery and make-up, she said.

Botswana has the highest rate of HIV prevalence in the world: nearly 40 percent of the adult population has the virus.

Women in both traditional communities and larger cities often seek in vain for justice, and are stymied by the silence or indifference of even neighbours and colleagues.

"In my neighbourhood in Cape Town, there were two scandalous cases, a girl now aged 13 who was raped at eight by her mother's boyfriend, and another, now aged 20, who was raped at 14 by her uncle," said Dubula.

"Both now have AIDS. Their cases have never been taken up. We have a problem with our judicial system and our police force, which is overwhelmingly male and not interested in handling rape cases."

Many young women become infected through migration. They move from the countryside to the city, where poverty forces them into prostitution.

Stephen Lewis, UN Secretary General Kofi Annan's special envoy on AIDS in Africa, warned on Sunday that even basic health care in Africa was biased against women, despite their role as essential caregivers.

"The one foolproof way to reduce the orphan population is to keep the mothers alive," he said, referring to the 11 million children who have lost parents to AIDS.

AIDS also reaps victims among those who are not infected.

If a parent dies of AIDS, it is likelier to be the girl who is pulled out of school, rather than the boy, to care for the family.

And in many countries, a woman widowed by AIDS may lose any right to inherit her husband's estate, for it can be transferred to his family under tribal practices that are often codified into law, Human Rights Watch says in a report due to be published on Friday.

"The devastating effects of property rights violations -- including poverty, disease, violence and homelessness --- are only magnified and made more lethal for women who face the stigma of having been widowed by AIDS or who are themselves HIV-positive," it says.

Tackling these deep-rooted problems, through policy changes, legal reforms and altered male behaviour, is vital for Africa to survive the AIDS war, it warns.

The International Conference on AIDS and Sexually-Transmitted Infections in Africa (ICASA) -- runs until Friday in Nairobi.

By Wambui Chege

JOHANNESBURG (Reuters) - Former South African President Nelson Mandela said Monday that breaking the grip of a crippling AIDS epidemic in the country would need the kind of social revolution that dismantled decades of apartheid rule.

About five million people are infected with HIV in South Africa, making it the worst affected nation in the world. AIDS activists say the deadly pandemic is now the leading cause of death in the country, killing about 600 people a day.

"We are faced with the simple stark reality that HIV/AIDS threatens our future like nothing else has done for the last number of centuries," said Mandela. "The fight against AIDS will indeed require another social revolution."

The 85-year-old icon of the apartheid struggle has been at the forefront of a global campaign to prevent the spread of HIV/AIDS.

Monday at a special youth forum with Bill and Melinda Gates and his wife, former Mozambican first lady Graca Machel, Mandela said the responsibility for conquering HIV/AIDS lay largely with young people, the biggest drivers of the epidemic.

Young South Africans, often under great pressure to have sex at a very early age, account for at least 50 percent of the country's new HIV infections.

Mandela recalled how young people played a critical role in dismantling apartheid. A student uprising in Soweto in 1976 helped to galvanize international support for sanctions against the apartheid government.

Crushing AIDS, Mandela said, would require similar effort.

In particular boys and men in Africa had a special role to play in changing chauvinistic attitudes and reversing traditional roles which often relegate women to second-class citizens in society. HIV infection rates among females are about twice as high as males.

AIDS experts say girls and women are particularly vulnerable, often because they are unable to persuade their male partners to use condoms, widely considered the most effective protection against HIV.

Melinda Gates said hope for women was coming -- albeit not for another three to five years -- in the form of a vaginal suppository made from genetically engineered bacteria that women can use to block the transmission of HIV.

"Her partner doesn't need to know she's using it and she can protect herself against AIDS," Mrs. Gates said.

Mandela took up the AIDS cause as he began to hand over to his successor Thabo Mbeki in 1999, when the full extent of the South African AIDS epidemic became clear. The Nelson Mandela Foundation has played a major role in organizing youth education programs.