The Washington-based bank, which has poured 380 million dollars to date for national HIV/AIDS programs in South Asia, said a key obstacle in overcoming the problem was refusal of the political leadership to accept the fact that the disease had gained a foothold in the region.

"The leaders are in a state of denial and there is a very high level of discomfort to even talk about it," said Praful Patel, the World Bank Vice-President for South Asia.

He said the leaders thought "HIV-AIDS is an African problem and it cannot happen in South Asia," calling for a perception change in leadership "from the states at the ground level all the way to Prime Minister and head of state.

Patel, who took up his position recently after helping the bank combat the disease in Africa, said he experienced the same attitude among leaders in Africa about seven years ago when HIV/AIDS was emerging as problem there.

"We are facing exactly the same situation in South Asia now where this disease has gained a foothold and absolutely there is no serious strategy to address it," he said.

The Ugandan-born Patel said that to his amazement, during a recent trip to India, officials were quibbling about the estimated number of people suffering from the disease rather than moving on to plan strategies to combat the problem.

About eight million people in South Asia are living with HIV/AIDS, comprising nearly one fifth of the world's HIV infections, according to the United Nations.

Almost two-thirds or 4.6 million of those infected are living in India.

Although the infection rate in the population at large is still low due to its large population, India has one of the largest HIV-positive populations in the world, second only to South Africa.

Patel cautioned that the epidemic has already advanced into the generalised state in six of India's 28 states.

"Last week I was in three different states and I met the Chief Ministers. They were not interested when I tried to bring HIV/AIDS on the agenda," he lamented. "In fact, in one state, I tried very hard to bring this up three times."

Other countries in the region, such as Bangladesh, Pakistan and Nepal, are characterized by low prevalence among the general population but have significantly higher rates among subpopulations engaged in high-risk behaviours, such as injecting drugs with contaminated needles and those engaged in commercial sex.