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CAPE TOWN, South Africa — Though more than 22 million people have died of AIDS and 36 million others are infected with HIV, the pandemic is still in its early stages, the United Nations’ top AIDS fighter said Tuesday as he marked 20 years since the first official report of AIDS. 

If the world does not act decisively now, AIDS could spread to countries that have so far avoided the worst of the disease, Dr. Peter Piot, the head of UNAIDS, told The Associated Press. 

“When you look particularly at Asia at Western Africa at Eastern Europe it is clear that we are really at the very early phases of the spread of HIV,” Piot said in an interview. 

More than 70 percent of the people with the virus that causes AIDS are in sub-Saharan Africa, the poorest region in the world. Global health officials worry the disease could spread as rapidly through a country such as India, with a population of 1 billion, as it has through South Africa, where 11 percent of the country’s 43 million people are infected. 

Looking back, no one could have predicted the devastation that would be wrought by the disease first uncovered 20 years ago in a nine-paragraph write-up by the U.S. Centers for Disease Control about the strange deaths of five gay men, Piot said. 

In the early years of the disease, many predicted a quick cure – or at least a vaccine, Piot said. 

“I also thought that it would go away (as quickly) as it came up,” he said. 

Since then, an estimated 58 million people have contracted HIV. More than 22 million of them have died. A cure remains a dream for the infected. Efforts to find a vaccine continue. 

“This is now, without any doubt, the largest epidemic in human history, and we are certainly not at the end of it,” Piot told reporters Tuesday. 

The face of the disease has changed from that of a gay men or intravenous drug user in the United States, to that of millions of African men and women who contracted HIV through heterosexual sex and their babies, who got the disease simply by being born. 

The explosion of AIDS has proven how quickly a disease can spread across the globe in the newly connected world, Piot said. It has also taught the world a lesson in the devastation that can be caused when governments react too slowly. 

U.N. Secretary-general Kofi Annan has asked wealthy countries to contribute from $7 billion to $10 billion a year to a fund to help prevent and treat AIDS in the developing world, where the pandemic has hit worst. About half that fund will be earmarked to fight AIDS in Africa. 

The U.N. General Assembly has scheduled a special session from June 25-27 to discuss plans for fighting the pandemic. 

“There is this enormous momentum that is building up and growing internationally,” Piot said. 

Piot hopes the meeting, the first special General Assembly session ever dedicated to a disease, will produce a detailed declaration of commitment signed by every country in the United Nations. 

The declaration would need to bind countries to work toward prevention, educate young people about the disease and destroy the crushing stigma surrounding AIDS, he said. The agreement should also commit countries to solving the complex web of problems preventing those infected from receiving AIDS drugs. 

Those problems include the poor healthcare infrastructure in many of the worst-infected countries, people’s refusal to get tested for HIV, the costs associated with caring for those infected and the price of the AIDS drugs, Piot said. 

“Unfortunately, I think the focus has been a lot on the price of antiretroviral drugs, reducing an extremely complex problem into something that is simple on paper,” he said. 

Many of the hardest hit countries have detailed plans for fighting the disease, plans that, if implemented, could signal a turning point in the pandemic, Piot said. 

But the worst infected countries in the world are also some of its poorest, and they need massive and sustained help from the developing world, he said. 

“There’s not a lack of ideas, of strategies of what to do, but there’s a lack of cash,” he said. 

On the Net: 

Joint United Nations Programme on HIV/AIDS, http://www.unaids.org 

Treatment Action Campaign site for AIDS in Africa, http://www.tac.org.za