The Associated Press; 50 Rockefeller Plaza, New York, NY 10020 - Monday, November 3, 1997; 4:31 p.m. EST
Harry Dunphy, Associated Press Writer

The report recommended fast, intensive prevention efforts in countries where AIDS is just starting to appear, especially among people who have many sex partners or inject drugs, saying millions of lives could be saved. Approximately 90 percent of all HIV infections occur in developing countries.

Sub-Sahara Africa has the most people infected with AIDS -- 14 million -- but new evidence in the report suggests the virus may be on the verge of exploding in parts of China, India, Eastern Europe and the former Soviet Union.

The report does not cover the United States and other industrialized nations.

In some countries life expectancy was 10 to 20 years shorter than it would have been in the absence of the AIDS epidemic, said Joseph Stiglitz, the bank's chief economist and a former adviser to President Clinton.

The international lending agency is one of the largest sources of money for AIDS prevention, having committed $632 million to 61 projects in 41 countries.

Stiglitz said the report differs from many other studies of AIDS by focusing on how best to allocate scarce government resources and international funding for cost-effective responses to the disease.

Martha Ainsworth, a co-author of the report, said countries that believed AIDS would not become a problem are now experiencing serious epidemics.

"By the time many AIDS cases are observed it is too late to avert a serious epidemic," she said. "HIV will already have spread widely."

Among those in the riskiest category are people who have unprotected sex with many partners -- truck drivers, migrant workers, bar workers and the military, the report said.

The report said programs that make it easier for injecting drug users to get sterile needles also have been highly effective in preventing the spread of AIDS.

Asked if the bank advocated needle-exchange programs, Richard Feacham, director of the bank's health department, said the bank's role was to provide governments with information so they can decide. He said the bank was prepared to pay for such programs if asked by a government.

Ainsworth and Feachem both said treatment for AIDS patients available in the West was too expensive for developing countries. They said it was better for available funds to be spent on prevention.

Copyright 1997/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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