However, nearly half -- up to 43 million HIV infections -- could be averted across Africa if leaders take the right steps and significant foreign aid is forthcoming, said the report entitled "AIDS in Africa: Three scenarios to

"Millions of new infections can be prevented if Africa and the rest of the world decide to tackle AIDS as an exceptional crisis that has the potential to devastate entire societies and economies," said Peter Piot, the head of the UN agency leading the fight against HIV/AIDS.

Piot warned that the evolution of the AIDS epidemic in Africa over the next 20 years would be based on "decisions taken today by African leaders and the rest of the world".

If African governments implement effective polices but foreign aid is insufficient, less than half that number of new HIV infections -- some 23 million -- could be averted by 2025, the UNAIDS report said.

A third scenario of a failure by both African governments and the international community to tackle the problems foresees increasing poverty and underdevelopment across the continent even if infection rates remain stable at about five percent.

UNAIDS warned that would also cause huge economic costs, while health and support systems would be "underdeveloped and overwhelmed".

Ethiopian President Girma Woldegiorgis said at the presentation of the report: "At a time when there is increased willingness to tackle AIDS in Africa, we must galvanise all resources -- human and financial -- and use them effectively for sustainable change."

The worst case scenario highlighted seven "traps" that could prevent all but the privileged in Africa from escaping high HIV rates.

They included the legacy of Africa's colonial history, its "cycle of poverty, inequality and disease" and the divisions in African society that feed the stigma surrounding AIDS.

The report also highlighted leaders and donors' desire to show quick results, which hampered the necessary investment in long term action, Africa's marginalisation from the process of globalisation, and its dependency on the "rhetoric" of donors.

The reponse to AIDS in Africa must also avoid "shortcuts and magic bullets", such as a focus on antiretroviral therapy at the expense of prevention when both are needed, it added.

In the gloomier of the three scenarios, just 20 percent of African HIV patients would have access to those anti-AIDS drugs.

The optimistic scenario, which expects global changes in trade and development polices to boost African economies, would see about 70 percent of HIV-positive people receive life-enhancing anti-retroviral drugs that suppress the virus by 2025.

However, that would involve a "considerable" increase in foreign aid, ranging well beyond health care, UNAIDS said.

"Not only is strong leadership vital, strong health systems and development are also necessary in our quest to control the AIDS epidemic," said Kenneth Kaunda, former President of Zambia, in a keynote address.

"AIDS is going to be around for a long time and needs consistent policy responses over several terms of government," he added.

The cumulative death toll from AIDS in Africa between 1980 and 2025 would range from 67 million to 83 million under the scenarios presented by the UN.

The study was initiated by UNAIDS in February 2003 in collaboration with the African Union, African Development Bank, and the World Bank. The oil giant Royal Dutch/Shell Group also shared expertise with the project.

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