“More than 20 years and 20 million deaths since the first AIDS diagnosis in 1981, almost 38 million people…are living with HIV,” asserts the UNAIDS in its newly released 2004 report.

Over the past decade, we have acquired crucial knowledge about how best to prevent the spread of AIDS and improve the quality of life for people living with HIV. Yet cures remain elusive, and many challenges lie ahead. The Winter 2004 MONITOR addresses these issues, providing both a global and regional perspective on the situation, as it scores the wins and losses, and reveals the most promising approaches to reverse the course of this devastating epidemic.

UNAIDS chief, Dr. Peter Piot, leads off with a situational analysis of AIDS around the globe, highlighting current trends, status and impact on the development of nations. He concludes with a discussion of the global challenges to HIV/AIDS prevention and offers a list of prioritized actions to help curtail the pandemic.

Peter Lamptey of Family Health International provides a compelling analysis of the health and economic damage HIV and AIDS wreak on women and children in sub-Saharan Africa – the “epicenter” of the epidemic – pointing to successes and questioning the adequacy of current approaches to prevent and minimize disease impact.

In the Insider’s View, Ravi Verma from the Population Council outlines the complex nature of the growing AIDS epidemic in India, pointing out that the traditional mores of Indian society must become an integral part of a comprehensive preventive strategy designed to reduce stigma and discrimination, and improve access to care and services across the country.

Using India, Russia and China as prime examples, Joan Tull of UNAIDS discusses the Global Media AIDS Initiative, which is designed to activate media organizations to disseminate information to youths in particular about how to prevent and treat HIV, and combat AIDS-related stigma and discrimination.

Russia has 800,000 HIV-infected persons and the worst prevalence rate in the Eastern European and Central Asian region; nevertheless, its countrywide tobacco addiction is giving AIDS a run for its money. CECHE News highlights the challenges and early successes of a CECHE-sponsored smoking-cessation program in Russia to combat this smoking scourge. This section also features a newly launched scholarship program to assist nutrition and public health scholars at Lady Irwin College in New Delhi, India.

Approaching AIDS from a policy perspective, Ambassador Randall L. Tobias reports on the U.S. Global AIDS Program, a presidential initiative that targets 15 of the world’s most affected nations and aims to prevent AIDS infections as it provides anti-retroviral treatment and care for those already infected.

This issue of the MONITOR leaves no doubt that the dynamic, growing and challenging AIDS epidemic requires an all-out war to increase research funding, as well as a global political commitment to expand access to HIV treatment.