World leaders, including a dozen heads of states and governments, gathered in New York on Monday to review the progress made in the fight against HIV/AIDS since the historic special session of the United Nations General Assembly on the subject two years ago.

According to reports by Secretary General Kofi Annan as well as by the Joint UN Programme on HIV/AIDS (UNAIDS), while progress has been made on some fronts since the 2001 meeting, there has been a lack of adequate response in many key areas by member states.

• SA, India lead in AIDS, UN told

"We have come a long way, but not far enough," Annan said addressing the plenary session of the UNGA at the start of the daylong meeting. "Clearly we will have to work harder to ensure that our commitment to the fight against AIDS is matched by the necessary resources and action."

Globally, there are about 42 million people living with HIV/AIDS and by far the greatest proportions are in the developing world. The impact of the disease has been particularly devastating in sub-Saharan Africa and is now spreading to populous countries like China and India.

Although both China and India have relatively low prevalence, the absolute numbers are very high because of their large populations. India, which has a prevalence rate of just one per cent, has an estimated four million people with HIV/AIDS, second only to South Africa in numbers.

The reports, which contain results of surveys conducted in 103 countries, state that the current pace of country activity on HIV/AIDS is insufficient to meet the 2005 goals agreed to by all nations at the special session. Those goals, which focus on the rapid expansion of HIV prevention care and impact alleviation programmes, are seen as a vital foundation to achieving the Millennium Development Goal of halting and reversing the epidemic by 2015.

One of the goals, for example, has been to ensure that by 2005 at least 80 per cent pregnant women have access to information, counselling and treatment to prevent HIV transmission to their children. But today these services remain virtually nonexistent in countries worst affected by HIV/AIDS.

"Today's reports are a dramatic wake-up call to the world," said Dr Peter Piot, executive director, UNAIDS, at the session. "The goals set up by the member states themselves two years ago must be met if we are going to have any realistic chance of reversing this devastating epidemic," he said.

Piot noted that while there has been some concrete progress, the current pace and scope of the world's response remains wholly insufficient. "The 2005 goals can still be met, but only if significantly greater and sustained commitments to the global HIV/AIDS epidemic are realised."

Spending on HIV/AIDS programmes in low and middle-income countries will amount to $4.7 billion in 2003 -- a 20 per cent increase over 2002 levels, but less than half of the $10 billion that will be required for an effective response to HIV/AIDS in 2005 alone.

Annan noted that the resources available must continue to increase through the Global Fund, and through all other efforts, including those of governments in heavily affected countries.

The Global Fund was founded in January 2002 to marshal financial resources and support programmes that will reach those people who are most in need of help.

Till date the Global Fund, which has Rajat Gupta, managing director, McKinsey and Company, as member of the board from the private sector, has approved grants to 93 countries, including those with the greatest disease burden and those at risk of future disaster. Approvals total $1.5 billion over the two years.

The need for increased finance and aid for developing countries was highlighted by a number of speakers, especially from the developing countries. Khurshid M Kasuri, foreign minister, Pakistan, said HIV/AIDS had not only brought development in affected countries to a grinding halt, it had reversed the achievements of several decades.

"The developed world must create an enabling international economic environment through enhanced debt relief, market access and official development assistance," he said.

Noting that against a projected requirement of $7 billion by 2007, international donors had pledged $4.7 billion, he said the amount received so far had not exceeded $1.5 billion. "Unless sustained with the requisite resources, the Fund would fail to meet its objectives. Pakistan urges the donor community to allocate additional resources to the Fund."