Only 30,000 people out of almost 30 million now living with HIV/Aids in sub-Saharan Africa are being given the drugs that keep infected men and women elsewhere in the world alive, well and working.

"It is," says Peter Piot, head of UNAids, the agency that coordinates anti-Aids campaigns around the world, "an enormous scandal."

In spite of the promises of help from rich nations over the past two years, a vast gulf still exists between those whose lives can be indefinitely prolonged by modern medicine and those who will die in the absence of treatment.

Last year 2.2 million Africans died of Aids. In rich countries, where 500,000 people are on HIV-fighting anti-retroviral drugs, 25,000 died.

According to the World Health Organization, 230,000 people in developing countries are on anti-retroviral drugs to keep HIV in check. But half of those are in Latin America - mostly in Brazil, which has used aggressive tactics against the pharmaceutical companies to obtain the drugs cheaply or has manufactured its own copies.

Aids will kill almost 70 million people over the next 20 years, according to a UNAids report on the HIV/Aids epidemic published in July. This is five times the number of deaths in the past two decades.

"Collectively, we have grossly, grossly underestimated how bad this was going to be," Piot says. "There has been basically no progress in prevention."

The report says India was home to almost 4 million infected people - more than any other country except South Africa.

UNAids warns of dangerous increases in China, which registered a 67% increase in reported HIV infections in the first six months of 2001. If no effort is made to step up prevention and education there, the number of HIV-infected people in China could rise to 10 million by 2010.

Unprotected sex in Europe and North America is leading to higher rates of infection there. Eastern Europe, with 250,000 new cases last year, is the region of the world with the highest rate of increase in new infections.

In 2001, an estimated 3 million people died of Aids.