That increase could be kept to 3 million if a response program is adopted immediately, according to the report from The Commission on Aids in Asia, which called for more involvement from political leaders, greater resources and stronger prevention programs to quell the epidemic.

Nearly 5 million people are infected with HIV in Asia now, with 440,000 dying annually, the report said. The annual death toll will rise to almost 500,000 by 2020 without a scaled-up response, according to the report, entitled 'Redefining Aids in Asia - Crafting an Effective Response.'

'By implementing the recommendations of the commission, Asian countries can avert massive increases in infections and death, prevent economic losses and save millions of people from poverty,' UN Secretary General Ban Ki Moon said in a statement.

The HIV epidemic in Asia is characterized by risky behaviour among three groups, the commission found: commercial sex workers and their customers, injectable drug users and men who have sex with men.

These groups should be the focus of prevention efforts to control HIV, Commission Chairman Chakravarthi Rangarajan told reporters at a briefing.

Most likely cause of death
Aids is the most likely cause of death and work days lost among 15-to-44-year-olds in Asia, according to the commission, which worked on the report for 18 months. Asia ranks second regionally in HIV cases behind Sub-Saharan Africa, which has an estimated 22.5 million people living with HIV.

Although prevalence rates are low in Asian countries, the large populations drive up the overall numbers, said Rangarajan, who is also chief economic adviser to India's prime minister.

The commission recommended a minimum annual investment of 30 US cents (42 Singapore cents) to 50 US cents per capita on focused prevention programmes.

By spending US$1 per person, the countries can implement a broader approach including treatment.

Government heads of state should directly become involved in HIV control efforts to show leadership, Rangarajan said, which has generally not occurred.

Prevention programs should take steps to ensure more extensive use of condoms, Mr Rangarajan said.

The commission said efforts to develop policies to combat HIV also must directly include the communities most affected by the disease.

Governments also need to repeal or change laws that foment HIV-related discrimination, the report said.

'It shows clearly that the response to the epidemic has to be tailored to Asian realities,' Peter Piot, Director of the Joint UN Programme on HIV/Aids, said at the briefing. 'There is not one Asian reality, there are many. The time is gone that with a blueprint for the whole world we can stop this epidemic.' -- REUTERS