Africa: Scaling Up the Response To the HIV/AIDS Pandemic (CRS Report for Congress)
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| Release Date |
May 29, 2002 |
| Report Number |
RL30883 |
| Report Type |
Report |
| Authors |
Raymond W. Copson, Foreign Affairs, Defense, and Trade Division |
| Source Agency |
Congressional Research Service |
Summary:
Sub-Saharan Africa's AIDS pandemic continues to spread -- an estimated 3.4 million people
were
newly infected by HIV in 2001. International resources for combating the pandemic are increasing,
and there is continuing interest in proposals for a further "scaling-up." In December 2001, the
House passed the Global Access to HIV/AIDS Prevention, Awareness, and Treatment Act
( H.R. 2069 ), finding that the African pandemic has become a national security and
development crisis and authorizing increased funding.
AIDS experts see three dimensions to the effort to curb the spread of HIV/AIDS and reduce the
death toll: prevention, care, and treatment. They estimate that by 2005, Africa could effectively
absorb about $4.6 billion in the struggle against the pandemic and that about $3 billion would have
to be provided by donors. Donor contributions were estimated at several hundred million dollars in
2001, and whether they will be providing $3 billion annually by 2005 remains to be seen.
Nonetheless, HIV/AIDS assistance from the United States and other donors has been
increasing.
U.S. bilateral spending on African AIDS programs is expected to rise from $238 million in FY2001
to $292 million in FY2002. The United States has pledged $500 million to the Global Fund to Fight
AIDS, Tuberculosis, and Malaria, which announced its first grants in April 2002. About 52% of the
$378 million to be initially disbursed will go to Africa. The scale of future increases in U.S.
spending is unclear; but several bills that would boost the U.S. contribution are currently before
Congress.
The focus in the struggle against AIDS in Africa to date has been on prevention -- only an
estimated 25,000 to 30,000 African AIDS patients are currently receiving treatment with the
antiretroviral drugs that have sharply reduced the AIDS death toll in developed countries. AIDS
experts favor a continued scaling up of prevention measures, including media campaigns,
school-based programs, and condom distribution. At the same time, there is strong support for
expanding the availability of antiretrovirals to prevent mother to child transmission of HIV during
birth.
Beyond prevention, many advocates want to enhance home-based care for AIDS patients and
their families and sharply expand programs to care for Africa's burgeoning population of orphans.
Many also believe that antiretroviral treatment must be made much more widely available, both on
moral grounds and because it can stem the loss of adults in their most productive years.
In addition to governments, non-governmental organizations, foundations, and the private
sector
are expanding their involvement in the campaign against AIDS in Africa. Community and
faith-based organizations are playing key roles in caring for those affected by AIDS, including
orphans and vulnerable children. U.S. government agencies, meanwhile, have undertaken steps to
enhance their policy making and coordination capabilities, although some observers would like to
see additional efforts in this area.
