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HIV, AIDS infections said leveling off: Is global epidemic ending?

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(CBS/AP) The United Nations is optimistic AIDS can be eradicated, after a new report on Monday said the AIDS epidemic is leveling off and the number of newly infected people with HIV remains unchanged since 2007. But without a vaccine, millions left untreated, and donations drying up amid the economic crisis, critics aren't getting too excited.

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"They need to get real," said Sophie Harman, a global health expert at City University in London, who wasn't connected to the report. "Maybe they need to aim high, but if their main goal is eradication, it's highly unlikely that will ever happen."

There were 2.7 million new HIV infections last year, approximately the same figure as in the three previous years, said the UNAIDS report. At the end of last year, 34 million people had HIV. While that is a slight rise from previous years, experts say that's due to people surviving longer. Last year, there were 1.8 million AIDS-related deaths, down from 1.9 million in 2009.

The outbreak continues to hit hardest in southern Africa. But while the number of new infections there has fallen by more than 26 percent since the peak in 1997, the virus is surging elsewhere.

In eastern Europe and central Asia, there has been a 250 percent jump in the number of people infected with HIV in the past decade, due largely to the spread among injecting drug users. In North America and western Europe, the outbreak "remains stubbornly steady," the report said.

In its strategy for the next few years, UNAIDS says it is working toward zero new HIV infections, zero discrimination, and zero AIDS-related deaths.

"It's looking promising, but the numbers are still at a scary level," Harman said.

Dr. Paul De Lay, deputy executive director of UNAIDS, acknowledged that eliminating AIDS infections and deaths is "more of a vision for the future," and would likely not be accomplished without a vaccine, which could take decades. Earlier this month, Secretary of State Hillary Clinton called for an AIDS-free generation and promised more money for programs in Africa.

De Lay said U.N. strategies will focus on more aggressive prevention and treatment policies, like treating people with HIV before they get too sick. In Africa, people with HIV are not usually treated until their immune system reaches a certain threshold.

Future strategies might also include giving medicines to people at high risk even before they get infected. The World Health Organization is considering how to advise countries with major epidemics on preventively giving drugs to vulnerable groups such as prostitutes, gay men, and injecting drug users.

While studies have shown that could dramatically slow AIDS transmission, experts have voiced concerns about healthy people taking AIDS drugs - which have toxic side effects - that could encourage drug resistance.

Sharonann Lynch, an HIV policy adviser at Doctors Without Borders, said many African countries are anxious to implement more aggressive strategies, with some redrafting guidelines even before official U.N. advice is available. But she said the financial crisis is affecting treatment and that enrollment in some clinics, like in Congo, have been suspended, potentially allowing the epidemic to resurge.

"Just at the moment when we know how to manage HIV, we're hitting the brakes," Lynch said. "Without more investment, we'll be squandering the best chance we have of getting ahead of the new wave of infections."