By the end of 2003, China had some 850,000 people living with the human immunodeficiency virus (HIV) or AIDS, Shao Yiming, chief expert at China's National Centre for AIDS/STD Control and Prevention, told a conference.

China's prevalence rate today is very small compared with its population of 1.2 billion, but the epidemic is so complex and fast-moving that "we are projecting that by 2010, there could be 10 million cases," he said.

"We are at a critical stage in which the epidemic could spread from high-risk groups to the general population," Shao warned.

The first cases of HIV in China surfaced in the late 1980s among injecting drug users in the southwestern province of Yunnan, an inflow for narcotics from the Golden Triangle region, he said.

In the mid-1990s, a major epidemic broke out in the central province of Henan, caused by tainted needles used in blood donations.

The Chinese news website sina.com on Friday reported that almost 10 percent of the 280,000 people who sold blood in Henan during this time were HIV positive, a figure that is nearly double the 14,500 previously reported by the province.

The epidemic is now flourishing along the bustling southern coast, driven by the mingling of prostitutes and migrant labourers, Shao said.

Looking to India -- with a billion people the world's most populous country after China -- US expert Thomas Quinn said "there is no doubt that the country faces a public health crisis."

Data about the epidemic is so sketchy or unreliable that "no-one really knows what the situation is," said Quinn, an 18-year veteran of AIDS in India who is also head of international AIDS and sexually-transmitted illnesses at the US National Institute of Allergy and Infectious Diseases (NIAID).

Various estimates, by Indian or international agencies, say India has between five to eight million infections, 60 percent of whom are co-infected with tuberculosis.

By 2010, that could be 20-25 million, according to a 2002 estimate by the US National Intelligence Council (NIC).

"India has at least 12 percent of the total of global infections. Every fourth newly-infected person in the world is an Indian," said Quinn.

Prostitution is India's biggest risk, for men become infected from sex workers, and go home and then infect their wives, who can then pass it on to their baby if they are pregnant.

Among prostitutes in Mumbai, "the infection rates have taken off... 60-70 percent of commercial sex workers there have HIV," he said.

Quinn said that, after years of denial, the authorities were at last giving a strong political push to combatting the epidemic but the country's pharmaceutical business -- the biggest producers of generic drugs in the world -- had still to play their part.

"Triomune is more expensive in India than in South Africa," he complained, referring to a three-in-one copycat anti-HIV drug, made by Cipla Laboratories, that South African AIDS activists say can be bought for as little as 150 dollars per person per year.

"It remains about 500 dollars a year in India, which is more than many patients can afford. It's almost as if they've taken South Africa and other places as markets where they can compete against the trade drugs."

The two-day conference was organised by the Royal Society of Medicine and the US National Institutes of Health.

But the country is so big and the statistics so sketchy that some experts believe the figure could be two or three times as much.

Shao said it was possible that the toll could reach 10 million cases by 2010.

Epidemiologists are hard at work in badly affected regions trying to get a fix on the numbers, and their report would in turn be a factor on the decision on compulsory licensing, he said.

In a two-week stretch this summer, 100,000 blood donors were tested for HIV in Henan, the central province that is reeling from an explosion in infection rates triggered by illegal blood donations in the 1990s, Shao said.

The drugs decision lies with the National Executive Committee, which is chaired by the vice premier and includes the ministers and vice ministers of about 22 ministries.

In addition to buying the imported HIV drug 3TC from GlaxoSmithKline, China already makes five generic HIV drugs whose patents has either expired or is not legally protected in China. They are AZT, ddI, nevirapine, D40 and indinavir.

Shao said it was essential for China not only to broaden this arsenal in the face of the drug resistance.

Compulsory licences are supposed to be issued only in cases of extreme urgency or national emergency, or if a government has failed to get reasonable commercial terms from the pharmaceutical corporation.

In addition, the licences are supposed to be limited in scope and duration, for the treatment only for domestic patients, without resale to other markets, and for a limited number of years.

Western pharmaceutical giants had fought bitterly against compulsory licences, describing them as legalised piracy that would sap the profit motive that spurs drug innovation.

Students will be taught about HIV/AIDS in order to raise their awareness about the disease and to dispel misunderstandings and discrimination, the Chinese News Service reported Thursday.

The guidelines were issued by the State Council AIDS prevention work committee.

Years of official denial and public ignorance have fuelled the spread of AIDS in China.

Until recently, China denied it had a serious problem but national leaders have now begun acknowledging that urgent action was needed to curb its spread.

China says it has an estimated 840,000 HIV/AIDS patients, although international activists say it is much higher.

Intravenous drug users remain the nation's highest risk group.

Their early death will inflict crippling blows to their national economies and social fabric, furthering the potential for civic unrest and friction with neighbours.

"HIV/AIDS does not by itself cause wars and insurgencies, but it is severely destabilising in several ways," said Joep Lange, a University of Amsterdam professor who co-organised the International AIDS Conference in Bangkok in July.

"South Africa, Botswana and Swaziland will be potential basket cases if they don't act, and in the case of Botswana, if it doesn't act, it will cease to exist," he warned.

Countries whose economies, social cohesion and government have collapsed because of AIDS "can strike at the security of the international system," for they can plunge into civil war, ignite regional conflicts or become boltholes for terrorists, Lange said.

"AIDS is a major threat, on a country-by-country basis and on the global level," said Alan Whiteside, a professor of economics at the University of KwaZulu-Natal, South Africa.

Referring to Somalia as an example of a chaotic state that existed only in name, he said "it is entirely possible that there will be a (similar) doomsday scenario for some countries" which face soaring HIV rates, he said.

He cited Zimbabwe as a case where a rampaging epidemic had encouraged autocratic government and economic collapse, and expressed concern for Malawi, Swaziland and Botswana.

However, poor but well-led countries can unify in the face of AIDS, he said, citing Uganda, where the adult HIV rate has fallen from double figures to five percent in 15 years.

The two-day overview in London on the world's AIDS crisis is being staged by the Royal Society of Medicine and the US National Institutes of Health (NIH).

The feared link between AIDS and security began to be aired in 2000 but data to back the theory remains sketchy and the evidence is mostly demographic, Lange and Whiteside said.

The adult infection rate is 38.8 percent in Swaziland, making it the highest in the world, while 37.3 percent are infected by HIV in Botswana and 25 percent in South Africa, according to UNAIDS figures.

In seven sub-Saharan countries -- Zambia, Zimbabwe, Swaziland, Central African Republic, Lesotho, Mozambique and Malawi -- the life expectancy of a child born there today is blow 40, the UN Development Programme estimates.

Africa's 12.3 million AIDS orphans are a long-term source of turbulence, for they are vulnerable to crime, prostitution and child-soldiering, Lange said.

The military are another risk, Lange said, citing studies which said HIV prevalence in the armies of Congo and Nigeria were between 10 and 20 percent, between 15-30 percent in Tanzania and 40-60 percent in Angola.

"A military force that is sick and dying will not be effective... and become an increasing source of instability inside a nation and for its neighbours," Lange said.

As for AIDS' macroeconomic impact, Stevan Lee, with Britain's Department of International Development, said conventional models showed a major epidemic of HIV/AIDS reduced gross domestic product growth by 0.5-2.0 percent per year.

"This may seem relatively small, but in fact it's punitive," Lee said, "Over a 20-year period that's going to leave an economy in a very serious situation."

A far darker scenario, which Lee described as "a bit unrealistic," is the "unstable" model which says that very heavily-affected countries may be pushed towards a "tipping point" -- de facto collapse -- by AIDS.

"Of the 40 items of equipment required by blood banks, the available items at the time of the audit ranged from four to 12."

The report follows the detection of some 278 donors, among them 189 security personnel, whose blood tested HIV-positive during laboratory tests.

According to state health authorities, they were not informed of their HIV-positive status but their blood was destroyed.

"The infected persons were not informed of their HIV infection. As a result, 278 such persons in the state have been unknowingly spreading the deadly disease among the state's population," the report said.

Health officials said they only inform those who ask about their tests.

The report has sparked alarm among healthcare groups in the region.

"If blood banks do not have adequate infrastructure for conducting tests ... it could have dangerous implications and pose a serious threat to the entire population at large," S.I. Ahmed, chairman of the Assam AIDS Prevention Society, a frontline community healthcare group in the adjoining state of Assam, told AFP.

India's northeast borders the heroin-producing "Golden Triangle" of Laos, Myanmar and Thailand and has high rates of intravenous drug use -- a key cause of HIV infection here.

"The fight against AIDS remains one of our top priorities, since this disease ... is spreading at a worrying rate in the countries of eastern Europe and the former Soviet republics," Marc Danzon, who was re-elected for a second term on Tuesday, told AFP.

"All patients have to be treated, especially in the poorest eastern European countries, where less than two percent of AIDS sufferers have access to anti-retroviral treatment compared to 90 percent in western Europe," he said.

Calling for intensified efforts to prevent and treat AIDS, Danzon said he feared "a real explosion of AIDS in eastern Europe, which will spread to western Europe since this disease knows no boundaries."

In June, the WHO estimated that there were 475,000 patients in Europe in need of highly-active anti-retroviral treatment, known as HAART. Of those, 291,000 were under treatment, most of them in western Europe.

Danzon noted that treatment varied considerably from western to eastern Europe: in the former the need for treatment is expected to rise by 10 percent each year, while in the latter it is predicted to soar by more than 500 percent by 2010.

In August 2004, the 52 European WHO member states reported that a total of 785,000 people were infected with HIV, compared to 584,000 in 2001. Some 165,000 deaths were reported, up from 152,000 in 2001.

According to UNAIDS and the WHO, 1.94 million people in Europe were suffering from HIV/AIDS at the end of 2003, up by 25 percent from December 2001 when 1.55 million were infected.

TOKYO (AFP) - For the last five years, gynecologist Tsuneo Akaeda has been venturing into the heart of Tokyo's clubland to raise the alarm over the spread of AIDS in Japan, a predicament he warns "is soon going to explode".

The 60-year-old director of the Akaeda Roppongi Clinic gives out free advice to young people at a bar in Tokyo's pulsating nightlife district of Roppongi. Since 1999, he's seen over 2,000 of them.

"Japanese people think that AIDS isn't real, they have no awareness and don't feel directly affected," Akaeda, 60, tells AFP. "Young people think it's cool to have sex without a condom."

Japan is the only developed nation in which AIDS is on the increase, and health campaigners like Akaeda are determined to tackle the problem.

The tally in 2003 set a record since the first case was tracked in 1985. The government counted 336 new cases of AIDS, of which 67.6 percent were caused by sexual contact.

But only 640 were found to be infected by HIV, the virus that causes the condition, far lower than expected.

"The HIV cases should number about 10 times the AIDS cases, but only 640 have been counted. So where are the other infected people?" Akaeda asks.

The answer is clear, according to Masanori Suzuki, chief of the AIDS Health Care Section at the health ministry: "There are probably more cases than the number that have been proven and verified."

Wataru Sugiura, head of the Laboratory of Therapeutic Research and Clinical Science at the national AIDS Research Center, estimates that there were "three or four times the number of HIV/AIDS cases than statistics show," adding that the number of total cases has tripled in the last 10 years.

Excluding those infected by tainted blood transfusions, there were 2,892 AIDS patients reported in Japan at the end of 2003 while the HIV cases came to 5,780.

"Japanese people don't get themselves tested. For young people, free testing conflicts with their schedules," Dr Akaeda argues.

Home-delivery prostitution, known as "delivery health", has become a major new factor in the spread of the sydrome, along with the existing problem of sex tourism abroad, the doctor says.

The many Japanese who do not use condoms have also multiplied the risks of transmission, he adds.

Condoms are more often associated with contraception than disease prevention in Japan, agrees the health ministry's Suzuki, warning that "sales of condoms are on the decline."

Akaeda says there are a lot of young people who are unaware they are HIV positive, since symptoms can remain dormant for a decade. Japanese HIV cases in Japan were concentrated among people aged 20 to 34 years old last year, government data showed.

"The young people I see drink and smoke a lot and have very fragile health," he says. "I think that in the next five or six years, there will be a surge in the number of new cases."

But he complains the government "had no will at all" to fight a condition it does not consider serious.

"The government has a budget to fight AIDS, but it is happy just to edit brochures," says Akaeda.

He continues to wage his own battle. Sitting at a table with flyers in front of him, he is visited both by young people with HIV/AIDS who ask him how to live a normal life, and by others who are not infected but who want to know about to stay safe.

Akaeda also has a radio show called 'Girls Guard' which has raised his own profile, and he makes occasional 'drop-ins' on other bars in Roppongi.

He is urging more sex education in schools because young people do not receive information from anywhere else about the condition.

Teachers in Japanese schools who discuss sex with pupils risk getting complaints from parents, who fear that talking about it will only get their children more interested.

Sugiura adds that discussion of AIDS is no longer taboo but it remains a touchy subject to talk about.

"It's a problem that people don't want to hear about," Sugiura says, adding that the government should launch an educational campaign. "I have never seen an advertisement about it on television."

"The number of new cases are definitely going to increase in the next four or five years," Sugiura says.

The health ministry said that its testing centers are open on weekends and it is has increased the number of free tests it offers, but Akaeda says: "It's already too late."

The Japanese government agreed on Wednesday to provide US$890,000 (euro 737,000) to help fight AIDS in four Central Asian nations, Kyrgyzstan's Finance Ministry said.

Under an agreement signed by Japan, the World Bank and Central Asian officials, the money will be used to prepare the launch of a US$25 million (euro 21 million) anti-AIDS project, the ministry said.

The five-year project, funded by the World Bank and Britain's Department for International Development, is to be launched in 2005 and is aimed at curbing the spread of AIDS and minimizing its potential economic and social impact on the region.

Kyrgyzstan, Tajikistan, Uzbekistan and Kazakhstan will benefit from the project.

According to official figures, the four countries have a total of about 90,000 HIV-infected people. However, experts believe the real number may be 10 times higher.

The rapid spread of the disease is driven by the increasing use of intravenous drugs in the impoverished region, which is a major trafficking route for drugs from Afghanistan. Other causes are an increase in prostitution and cross-border migration.

BUCHAREST, Romania - The United Nations called on Romanian authorities to help the thousands of HIV infected children here attend school with other children, in a statement released Tuesday.

Less than 60 percent of Romania's 7,500 HIV infected children attend public schools, the U.N. Children's Fund said. Most of those who do go to school are able to do so only because they've kept their illness secret, the group added.

AIDS groups in Romania have in the past complained about discrimination against infected students despite a law that gives them the right to study.

"When an HIV positive child is not allowed to attend a mainstream school it means that the teachers, the other children's parents, and the community itself have a lot more to learn about HIV/AIDS," Pierre Poupard, the UNICEF representative in Romania, said in the statement.

His agency on Tuesday launched an initiative to promote equal education opportunities for all Romanian children. The agency wants local authorities to develop policies on the integration of HIV positive children in schools.

About 10,000 Romanians are infected with HIV. Most were infected by transfusions of blood containing the virus and by injections with tainted syringes. About 90 percent of children with HIV were infected in hospitals.

Late communist dictator Nicolae Ceausescu ignored the existence of AIDS and took no measures to prevent its spread.

There was no immediate from authorities about the UNICEF statement.