AIDS is now among the most devastating diseases in human history

And yet infection by HIV can be avoided. All that is required is for all people everywhere to be given the information, education, skills and full access to the ways they need to protect themselves and others. Male and female condoms are an essential component of such efforts and expanding and improving condom promotion and distribution are absolutely vital to success in the fight against the spread of AIDS.

The fact that condoms can save lives is indisputable. It is also a fact that a great many people in every country have no alternative to condom use for protecting themselves or their sexual partners, wives or husbands from infection. Prevention efforts that do not include condoms are therefore incomplete and will ultimately be ineffective.

Although the promotion and distribution of condoms have increased significantly since the onset of AIDS, the need for both promotion and distribution still far outstrips the resources committed. It is estimated that a minimum of 8 billion condoms would have been needed in 2000 in order to achieve the kind of access required for significant reductions in the rate of infection and prevalence in the developing world and Eastern Europe. Donors provided just 950 million condoms that year, less than one-eighth of the number needed. And while more developing country governments are allocating resources for prevention, national commitment remains inadequate.

With this report, Condoms Count: Meeting the Need in the Era of HIV/AIDS, Population Action International (PAI) continues its efforts to assess the world's progress towards achieving the reproductive health goals adopted by the international community. This report also complements the work by PAI and others to address the growing shortfalls of reproductive health supplies in many developing countries.

Supplies are, of course, only one part of the challenge in addressing poor reproductive health. This is particularly true with regard to the fight against HIV/AIDS, which requires significant changes not only in public policy, but also in individual attitudes, behaviors and in societal norms. Addressing poverty and the roots of gender inequities is key to such change.

To be effective, HIV/AIDS prevention programs must include a range and mix of interventions tailored to the specific needs of various groups and localities. The range must include promotion of the "ABCs" of prevention: abstinence, being faithful to one's partner, and condom use by the sexually active. And the mix of interventions must always include condoms — a most basic reproductive health technology that provides dual protection from infection and pregnancy. The international community, especially donor nations and institutions, must act quickly to mount large-scale comprehensive prevention efforts that strongly support promotion and distribution of condoms.

Failure to act is already having tragic consequences, particularly in sub-Saharan Africa where last year 2.2 million people died of AIDS and 28 million currently live with HIV/AIDS and where, in high prevalence countries, at least a third of boys now aged 15 will die of AIDS.

These horrifying statistics for Africa presage the future for other regions and countries unless preventive action — including widespread condom promotion and distributionСis immediately intensified. Despite the hold that HIV currently has on sub-Saharan Africa and, increasingly, on the world, we may one day look back upon this time as a moment of opportunity, when concerted prevention efforts could have made — or did make — a huge difference.