The UNAids report warns that 20 years after Aids first emerged the disease is still in its early stages.

Millions of people across the world have already died from the disease and on current predictions millions more will die in the years ahead.

There is a perception that the problem is over in the West but we are playing with fire at the moment

Dr Peter Piot believes that while major progress has been made much more work is needed.

"If the current level of efforts remain as modest as they are then the number of deaths could be even worse," he says.

"We still do not know how bad the situation is in India, China or the former Soviet Union, for example, and these are major populations. These are big countries where Aids is still in its infancy.

"Overall, we are still really in the early phases of the Aids epidemic."

In the past, it was thought that there was a natural ceiling to the Aids epidemic.

Early stages

It had been thought that infection rates and deaths would peak, especially in those African countries hid hardest by the disease.

However, latest figures from UNAids show this ceiling has yet to be reached prompting concern among experts and charities alike.

"I think one of the most surprising findings in our report is that in southern Africa we have still not reached the natural saturation level," says Dr Piot.

"In Botswana, almost 39% of all adults are infected and that is up from 36% three years ago. The disease is still progressing."

We are still really in the early phases of the Aids epidemic

However, there have been notable advances. The amount of money spent on tackling the disease - including medical research, health promotion and treatment - has increased from just $800m in 1999 to close to $3bn. Aids is also much higher up the global political agenda.

"Two years ago, there was no political commitment and no funding to speak of. Today, one can say that when world leaders meet they will talk about it. It was on the agenda at the recent G8 summit.

"The amount of money being spent has also gone up dramatically," he says. "We are entering a new era in terms of the global response to the disease."

Some advances

Huge strides have been made in the western world.

The number of people dying from the disease has fallen dramatically and new drug treatments have delivered major benefits for those infected with HIV.

However, the number of new infections is still high.

"Mortality has gone down tremendously. However, new infections have been at the same level for the past 10 years and that is worrying.

"We are also seeing a worrying increase in new cases of sexually transmitted diseases, like syphilis, which shows that people are still engaging in unsafe sexual behaviour.

"There is a perception that the problem is over in the West but we are playing with fire at the moment."

But this apparent progress hides strident failures to stem the spread of the disease in the developing world and Africa in particular.

We have still not reached the natural saturation level

"In western countries, half a million people are being treated for the disease and last year there were 25,000 deaths.

"In Africa, just 30,000 people are being treated and there were 2.2m deaths last year.

"That clearly shows the inequalities that exist across the world."

UNAids is at the forefront of efforts to introduce comprehensive prevention and treatment programmes

One of the major difficulties is the fact that Aids takes no prisoners.

Those who should head education campaigns - teachers, doctors, managers and politicians - are themselves dying from the disease.

"It makes the job of trying to respond to Aids even more difficult," says Dr Piot.

Conference focus

The UNAids chief hopes next week's international Aids conference in Barcelona will serve to focus minds on what needs to be done.

"Conferences like this one are always a major opportunity to draw attention to Aids throughout the world."

He adds: "My hope is that participants will go home with a sense of what they have got to do in their environment and those coming from wealthy countries will hopefully also devote some time and energy to solving problems in poor countries."

The XIV International Aids Conference runs from 7 to 12 July.