The report by UNAIDS — the U.N. agency responsible for coordinating global efforts to fight AIDS — said the worldwide epidemic killed more than 3 million people in 2003 and around 5 million more acquired the human immunodeficiency virus, or HIV.
"This year, more people became infected with HIV than any previous year before and more people then ever died from AIDS," Dr. Peter Piot, executive director of UNAIDS, told a news conference in London.
UNAIDS said the global response to the crisis has expanded significantly in the past two to three years with spending on anti-retroviral medication and education increasing in many countries.
"However, it is quite clear that our current global efforts remain entirely inadequate for an epidemic that is continuing to spiral out of control," said Piot. "AIDS is tightening its grip on southern Africa and threatening other regions of the world."
Kistan Shoultz, the country coordinator for UNAIDS in Kenya, said African governments needed to do more.
"I think that it would be OK to say that most governments are not doing enough right now — this requires huge resources, huge energy levels, far expanded efforts," Shoultz said in Nairobi.
The report said that anti-retroviral treatment coverage remains dismal in sub-Saharan Africa overall and basic knowledge of HIV/AIDS is still disturbingly low in many countries, especially among women.
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.
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.
The report said that voluntary counseling and testing services are virtually absent in many countries and only 1 percent of pregnant women in heavily affected countries have access to services aimed at preventing mother-to-child HIV transmission.
Dr. Jack Chow, who heads the World Health Organization's AIDS campaign, said the WHO was focusing on its "3 by 5" initiative, which aims to deliver anti-retroviral drugs to 3 million people worldwide by the end of 2005.
Piot said there was some positive news in the report, which was launched ahead of World AIDS Day on Dec. 1, with several countries making progress in combating the spread of the disease. Uganda was considered one success story, marking its 12th consecutive year of reduced HIV infections.
But the report said the epidemic in sub-Saharan Africa remains rampant and more recent epidemics in China, Indonesia, Papua New Guinea, Vietnam and several central Asian republics continue to grow. India is also a hotspot: About 610,000 Indians contracted HIV last year, increasing the overall number of infected Indians to about 4.5 million.
"This is an epidemic that at the start was a white middle-class gay man's disease," said Piot. "Today, if you use a stereotype, the face of AIDS is a young woman from Africa."
The report may renew 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 $2.4 billion for 2004.
Moreover, President 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.
According to the federal Centers for Disease Control and Prevention, there are roughly 800,000 Americans living with HIV and 40,000 new infections a year. Through December 2000, nearly half a million Americans have died from the disease.
An earlier U.N. study found that young people are increasingly responsible for the spread of HIV/AIDS around the world because of poverty and a severe lack of information and prevention services.
Every 14 seconds a person aged between 15 and 24 is infected with the virus. They now account for half all new cases of the disease, the U.N. Population Fund said in its annual State of the World's Population report.
In sub-Saharan Africa, which has the most cases of HIV/AIDS among youths, about 8.6 million have HIV/AIDS — two-thirds of them female. In South Asia, 1.1 millions youths are infected — 62 percent of them female. There is a continued risk of HIV concentrated among the poor and vulnerable in countries like Britain and the United States.