The world's largest global forum on AIDS opened here on Sunday amid dire warnings that a shortage of cash and lack of leadership threatened a health crisis in the world's most populous continent of Asia.
UN Secretary General Kofi Annan told world leaders to make good on their promise to tackle the AIDS pandemic as activists complained that governments across the world had broken their promises over AIDS funding.
In his speech to launch the 15th International AIDS Conference here, Annan noted many countries had sent health ministers to the event, but "the fight against HIV/AIDS requires leadership from all parts of government - and it needs to go right to the top.
"AIDS is far more than a health crisis. It is a threat to development itself," Annan said. "Leadership means showing the way by example."
The pandemic in 23 years has claimed more than 20 million lives and threatens 38 million more who are living with the human immunodeficiency virus (HIV).
Nearly five million more infections occurred in 2003, the highest in any single year, and officials at the forefront of the struggle warned that the world would have to improve or face dire consequences.
Women are increasingly bearing the brunt of the epidemic, yet one third of all countries still have no policies to ensure women have access to prevention and care, Annan said.
Experts have warned that HIV/AIDS in Asia has the potential to exceed the disaster in sub-Saharan Africa where the worst hit countries such as Swaziland and Botswana have HIV infection rates nearing 40 percent of the population.
Richard Feachem, director of the Global Fund to fight AIDS, Tuberculosis and Malaria, said disaster loomed if key contributors such as the United States and Europe failed to put up the 3.5 billion dollars needed for programmes in 2005.
"If the Global Fund cannot continue to grow in its support for programmes against AIDS, TB and malaria, the result is catastrophic, and we will not win," Feachem told reporters.
"We will not turn around the HIV/AIDS pandemic, we will not stop TB, we will not roll back malaria. It's absolutely black and white," he added.
Of the 4.8 million new infections last year, a quarter were in Asia, and big-population countries such as China, India and Indonesia are especially at risk, according to the UN.
In those countries, the epidemic is near the springboard point: after increasing slowly for a number of years in marginal groups such as gays, injecting drug users and prostitutes, the infection is about to leap into the mainstream population.
Thailand, the host country, was widely praised after quickly distributing condoms and launching anti-HIV programmes when the epidemic began to spread quickly in the middle of the 1980s.
However, the administration of Thai Prime Minister Thaksin Sinawatra, was criticised in a UN report last week for slashing funding, warning that the potential was there for a new surge in numbers.
As he officially opened the conference - the first in a developing Asian country - he was warmly applauded when he announced universal treatment coverage for HIV patients.
But demonstrators heckled the prime minister and unfurled a banner saying: "Thaksin Lies" in the middle of his speech as he addressed some of the 17,000 delegates set to attend over the next six days.
Earlier, about 1,000 people, most of them HIV-positive, protested outside the venue over the shortfall of cash to fight the global pandemic.