The figures are staggering. The picture is grim. Five million people were infected with HIV this year around the world, bringing to 40 million the number of people who are diagnosed with HIV/AIDS globally. At the same time, 3 million people – nearly 600,000 of them children under 15 years of age – died this year of the disease. Twenty years after the first cases of AIDS were reported, the disease over these two decades has infected more then 60 million people, and has been credited as the fourth leading cause of death worldwide. These are some of the findings of a United Nations report released on Wednesday, titled AIDS Epidemic Update 2001, which states that Eastern Europe and Central Asia are the frontrunners among regions where AIDS is still the fastest-growing epidemic. HIV is spreading rapidly throughout the entire Eastern European region – with a quarter of a million new cases just this year, said Dr Peter Piot, executive director of the Joint United Nations Program on HIV/AIDS (UNDAIS), in a statement on Wednesday. HIV/AIDS is unequivocally the most devastating disease we have ever faced, and it will get worse before it gets better. As many as 1 million people have been diagnosed with HIV/AIDS in Eastern Europe – both adults and children – while in Western Europe the number of reported cases has reached the 560,000 mark. According to the report, 250,000 new HIV cases were recorded in Eastern Europe, while the respective figure for Western Europe was 30,000. Both figures include adults as well as children under 15 years old. Of adults, women are in second place with 20 percent of HIV-positive cases in Eastern Europe and 25 percent in Western Europe. The findings of the UN report also show that the use of intravenous drugs is the most common method of HIV transmission both in Eastern and Western European countries, while in the latter the disease is also widely transmitted sexually among men who have the same sex partners. Western, Central Europe The UN report carries mixed messages for the continent, varying from region to region and country to country. In the high-income countries of Western Europe a pronounced rise in unsafe sex is triggering higher rates of sexually transmitted infections and, in some cases, higher levels of HIV incidence among men who have sex with men, the report notes. The rise in new HIV infection among men whose sexual partners are of the same gender is striking. In London, reported HIV infection among gay men is on the rise, as it is in Madrid where it almost doubled (from 1.16 percent to 2.16 percent). Rising incidence of other sexually transmitted infection among gay men in places like Amsterdam and London confirms that more widespread risk-taking is eclipsing the safe-sex ethic promoted so effectively for much of the 1980s and 1990s. The HIV epidemic in Western and Central Europe, the report declares, is the result of a multitude of epidemics that differ in terms of their timing, their scale and the populations they affect. Portugal faces a serious epidemic among intravenous drug users. Of the 3,733 new cases of HIV infection reported there in the year 2000, more than half were caused by intravenous drug use and just under a third occurred via heterosexual intercourse, the UN report says. Based on the same reports of new cases of HIV infection, findings also indicate that sex between men is an important transmission route in several countries, including Germany, Greece and the United Kingdom. Signs of hope? In Southeastern Europe, rates of sexually transmitted infection and transmission via intravenous drug use are also on the rise – although still at considerably lower levels than elsewhere in the region – and, according to UN estimates, due to increasing drug trafficking and the economic and psychological aftermath of recent conflicts, the likelihood that further HIV epidemics will erupt is increasing. Meanwhile, in Central Europe there is cause for tempered optimism as there is little indication, at this stage, of a potential rise in HIV infection. More than 150 HIV/AIDS prevention projects for intravenous drug users have been set up across the region in the past five years, along with projects focusing on other vulnerable populations such as prison inmates, prostitutes and gay men. By mounting a strong national response, the Polish government has successfully curtailed the epidemic among injecting drug users and prevented it from gaining a foothold in the general population, the report states. Prevalence remains low in countries such as the Czech Republic, Hungary and Slovenia, where well-designed national HIV/AIDS programs are in operation. But, as these HIV/AIDS prevention programs are getting under way on a national and regional level, the disease continues to kill in thousands in Europe. According to UN estimates, some 6,800 people, both adults and children, died this year of HIV/AIDS in Western Europe, while the figure for Eastern Europe reached the 23,000 mark. Based on the findings of the report, Western Europe comes after North America in recorded HIV/ AIDS cases, but when combined with the 1 million cases in Eastern Europe, the figure comes to 1,560,000, ranking the continent third after sub-Saharan Africa and Southeast Asia.