than in the rest of the world combined.
. Eastern Europe and Central Asia*/especially the Russian Federation*/continues to
experience the fastest-growing epidemic in the world; in 2002, there were an estimated
250,000 new infections, bringing to 1.2 million the number of people living with HIV/
AIDS. Uzbekistan, for example, is now seeing explosive growth: in the first six months
of 2002, there were almost as many new HIV infections as had been recorded in the
whole of the previous decade.
. In the USA, Canada, Western Europe and Australia we witness an increase of HIV
infections, notably amongst young gay men and migrant and other disadvantaged
populations.
. AIDS is systematically cutting down life expectancy in those countries where the
disease is most prevalent. Life expectancy has already dropped more than 20 years in
nine African countries. In Zimbabwe, life expectancy has dropped 32 years because of
AIDS.
548 EDITORIAL
. New treatments have opened many doors, but represent a challenge in terms of
delivery, access, adherence, quality of life and the challenges of living with HIV.
. The need to gather an evidence base for prevention and intervention planning has
never been so important. Stigma, discrimination and lack of human rights are often
the bedfellows of HIV. There is an urgent need to understand how these factors alter
the epidemic, impinge on prevention, divert HIV testing and affect quality of life.
. Bereavement, death and palliation are

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