More than 80 million Africans could die from AIDS-related causes by 2025, and the number of new HIV cases could increase to 90 million on the continent if more is not done to combat the spread of the disease, according to a UNAIDS report released on Friday in Addis Ababa, Ethiopia, the AP/USA Today reports (AP/USA Today, 3/3). The report, titled "AIDS in Africa: Three Scenarios to 2025," outlines three plausible scenarios of the African HIV/AIDS epidemic over the next 20 years based on the current actions of the global and African communities (Kaiser Daily HIV/AIDS Report, 3/2). It is based on UNAIDS projections made over a two-year period in collaboration with several institutions, including the African Development Bank, African Union, World Bank and Royal Dutch Shell (Tadesse, Reuters, 3/4). The scenarios include a "best-case situation," a "middle-case" condition and a "doomsday scenario," all of which "warn that the worst ... is still to come," according to the AP/USA Today. "What we do today will change the future," the report says, adding, "These scenarios demonstrate that, while societies will have to deal with AIDS for some time to come, the extent of the epidemic's impact will depend on the responses and investment now."

Scenario Details
The cumulative number of AIDS-related deaths in Africa from 1980 to 2025 would range from 67 million to 83 million under the three scenarios presented in the report, depending on the actions of African leaders and the amount of foreign aid allocated to the continent, according to AFP/Yahoo! News (AFP/Yahoo! News, 3/4). Under the worst-case scenario, a total of 89 million new HIV infections might occur between 2003 and 2025, compared with 46 million new infections during the same time period under the best-case scenario (Report text, 3/4). The "optimistic" scenario also predicts that 70% of HIV-positive people would receive antiretroviral drugs by 2025, compared with 20% of patients under the worst-case scenario, according to AFP/Yahoo! News. However, in order for the best-case scenario to be achieved, foreign aid to Africa would have to increase "considerabl[y]," AFP/Yahoo! News reports (AFP/Yahoo! News, 3/4). The report estimates that almost $200 billion over the next 20 years would be needed to avert 16 million AIDS-related deaths and 43 million new HIV infections in Africa, although donors currently have pledged "nowhere near that amount," according to the AP/USA Today. "If by 2025 millions of African people are still becoming infected with HIV each year, these scenarios suggest that it will not be because there was no choice," the report says, adding, "It will be because, collectively, there was insufficient political will to change behavior at all levels -- from the institution, to the community, to the individual -- and halt the forces driving the AIDS epidemic in Africa" (AP/USA Today, 3/3).

Reaction
"The scenarios highlight the various choices that are likely to confront African countries in the coming decades," UNAIDS Executive Director Peter Piot said, adding, "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" (Reuters, 3/4). "The scenarios provide us with glimpses into the future, so that we can make good decisions today," Ethiopian President Girma Woldegiorgis said, adding, "At a time when there is increased willingness to tackle AIDS in Africa, we must galvanize all resources -- human and financial -- and use them effectively for sustainable change" (UNAIDS release, 3/4).

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