UNITED NATIONS (Reuters) - Two decades after the first AIDS case was reported, the United Nations on Monday opens a high-level conference to combat the disease killing 5 million adults a year and creating a generation of orphans.

The appalling figures are not in dispute for the 3,000 government leaders, advocacy groups, scientists, businessmen, health experts and AIDS victims descending on New York for the first three-day special U.N. General Assembly session on AIDS.

Some 36 million people are infected worldwide with AIDS or HIV, the virus that causes it, with 25 million in Africa alone. The killer disease is rapidly spreading through Asia, the Caribbean and Eastern Europe.

"Everybody has come to this late,'' said Stephen Lewis, the U.N. AIDS envoy for Africa. "The world has been seized and galvanized only over the last 18 months or so. And in the meantime 17 million people have died in sub-Sahara Africa.''

There is also no dispute that billions are needed for poor countries to halt the devastation, which in Africa is wiping out large sectors of a productive work force.

But few agree on where and how to spend limited resources as they become available: on basic health services, on AIDS prevention campaigns or on antiretroviral treatment.

U.N. Secretary-General Kofi Annan has said $7 billion to $10 billion a year is needed. A new study in the journal Science estimates $9.2 billion is needed, about half for prevention campaigns, the rest for treatment.

RED RIBBONS FLYING

With red AIDS ribbons lighting up the New York skyline at U.N. headquarters, U.N. Secretary-General Kofi Annan is expected to make another appeal on Monday for funds for a global war chest to combat AIDS.

A multicolored patchwork quilt honoring the millions of lives lost to the pandemic will be rolled out symbolically to start the session. And dozens of demonstrations, panels and other events are scheduled throughout the city.

Two dozen presidents and prime ministers, almost all from Africa and the Caribbean, are attending the session. Secretary of State Colin Powell leads a 40-member American delegation that includes the head of Pfizer pharmaceuticals.

But delegates are still divided on a final declaration that would name homosexuals, prostitutes, prisoners and intravenous drug users among the most vulnerable groups. Muslim nations argue this would offend religious beliefs.

And U.N.-organized panels that include activists, major foundations and businessmen are in jeopardy. Egypt, Libya and Pakistan, among others, object to the participation of an American gay rights group, prompting Europeans and Canada to hold back approval of the non-governmental speakers list.

Nevertheless, Lewis believes progress is being made to ''slowly, incrementally, painfully turn things around.''

The U.N. Security Council has declared AIDS an impediment to peace and security, although the 15-member body this week is carrying out its full schedule, ignoring the conference.

Drug companies have slashed prices. And U.N. Secretary-General Kofi Annan has made the campaign his "personal priority'' while African leaders have been galvanized into action, Lewis noted.

Missing from the list of African leaders is South African President Thabo Mbeki, who will be in Washington this week. Mbeki caused an world furor last year when he questioned the link between the HIV virus and AIDS.

South Africa is among the worst affected nations, with about a fourth of the population facing an early death.

Officials from the Catholic Medical Mission, which cares for thousands of AIDS victims and orphans in southern Africa, say Pretoria is fumbling, even in providing drugs to stop pregnant mothers from passing on HIV to infants.

"We've heard that the whole plan has been abandoned. So even with an international conference, things are going backward,'' Johan Viljoen, a project manager, said.

Sister Alison Monro also is skeptical about the impact of the conference. "It may push the debate further but deliberations don't reach the remotest areas of sub-Sahara Africa, especially if health ministers are not delivering the goods,'' she said.

Dr. Peter Piot, executive director of UNAIDS, the coordinator of the U.N. programs, stresses that leadership, especially at the grass roots level "will ultimately be the driving force'' to reverse and halt the epidemic.

Uganda, with an early prevention program, has pushed down the HIV rate in adults from 14 percent to 8 percent over the last decade. Thailand, the Philippines and Senegal have taken bold steps to combat the disease. But only Brazil, among developing nations, is providing free antiretroviral treatment to the poor, cutting the death rate in half.

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