Unless there is a more comprehensive response to HIV/AIDS, the epidemic will remain out of control on its 50th anniversary in 2031, according to a panel of experts reported on in The New York Times. The analysis, led by former United Nations and International AIDS Vaccine Initiative policymaker Robert Hecht, was published November 2 in the journal Health Affairs.

According to Hecht, who is an economist, by 2031 developing countries will need $35 billion annually—three times what is currently spent—to provide HIV treatment, care and support. Even in a best-case scenario, the panel estimates, there will be more than 1 million new infections annually.

The economic models assume that while condoms, antiretroviral medications and circumcision would be widely available by 2031, a microbicide and an HIV vaccine would not.

In addition, the panel predicts that growing nations such as Brazil, China, India, Mexico and Russia will be able to fund responses to their own epidemics; in contrast, many sub-Saharan African countries such as Kenya, Mozambique, Uganda and Zambia will remain dependent on outside donors.

“We are staring at the face of a huge crisis,” Hecht said.